MY LOCAL COLORADO DENTAL PRACTICE, LLC
NPI 1548814262
Dentist - General Practice in Fort Collins, CO

Q: What is My Local Colorado Dental Practice, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since July 31, 2019

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

NPPES record last updated: July 31, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About My Local Colorado Dental Practice, Llc NPPES

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

MY LOCAL COLORADO DENTAL PRACTICE, LLC (NPI 1548814262), doing business as College Ave Modern Dental, is a healthcare organization registered as a general practice in Fort Collins, Colorado and active in the NPI registry since July 2019. The organization lists Michelle Johnson, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1548814262

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameMY LOCAL COLORADO 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

Phone(970) 233-8933

Organization SubpartYes

Authorized OfficialMichelle JohnsonCredentialing Specialist · (509) 315-8338

Enumeration DateJuly 31, 2019

✔ NPI 1548814262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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.

COLLEGE AVE MODERN DENTAL PRACTICE, LLC

Dentist

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 My Local Colorado Dental Practice, LLC's NPI number?

The NPI number for My Local Colorado Dental Practice, LLC is 1548814262. It was assigned to this organization in the NPPES registry on July 31, 2019. The provider is doing business as College Ave Modern Dental.

Where is My Local Colorado Dental Practice, LLC located?

My Local Colorado 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 My Local Colorado Dental Practice, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for My Local Colorado Dental Practice, LLC was last updated on July 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.