COLLEGE AVE MODERN DENTAL
NPI 1205358017
Dentist in Fort Collins, CO

Q: What is College Ave Modern Dental Practice, LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since July 13, 2017

3617 S COLLEGE AVE UNIT B, FORT COLLINS, CO 80525(970) 233-8933(888) 790-7062 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jul 13, 2017 (2 updates tracked since 2017).

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About College Ave Modern Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLEGE AVE MODERN DENTAL (NPI 1205358017) is a healthcare organization registered as a dentist in Fort Collins, Colorado and active in the NPI registry since July 2017. The organization lists Scott Frederick, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1205358017

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameCOLLEGE AVE MODERN DENTAL PRACTICE, LLC

Location Address3617 S COLLEGE AVE UNIT BFort Collins, CO 80525-3009

Mailing Address3617 S College Ave Unit BFort Collins, CO 80525-3009 · (970) 233-8933 · Fax (888) 790-7062

Phone(970) 233-8933

Fax(888) 790-7062

Organization SubpartNo

Authorized OfficialScott FrederickOwner/dentist · (970) 233-8933

Enumeration DateJuly 13, 2017

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1205358017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CO · 10115

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3617 S COLLEGE AVE UNIT B, Fort Collins, CO 80525

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Other Names 1

Doing Business AsCollege Ave Modern Dental

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MY LOCAL COLORADO DENTAL PRACTICE, LLC

Dentist (General Practice)

3617 S COLLEGE AVE UNIT B
FORT COLLINS, CO 80525

Larimer County (970) 233-8933

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is College Ave Modern Dental Practice, LLC's NPI number?

The NPI number for College Ave Modern Dental Practice, LLC is 1205358017. It was assigned to this organization in the NPPES registry on July 13, 2017. The provider is doing business as College Ave Modern Dental.

Where is College Ave Modern Dental Practice, LLC located?

College Ave Modern Dental Practice, LLC is located at 3617 S College Ave Unit B, Fort Collins, CO 80525. The listed phone number is (970) 233-8933.

What is College Ave Modern Dental Practice, LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for College Ave Modern Dental Practice, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.