PEDIATRIC DENTAL GROUP OF EVERGREEN
NPI 1619774528
Dentist - Pediatric Dentistry in Evergreen, CO

Q: What is Pediatric Dental Group Of Evergreen's NPI number?

The NPI number for Pediatric Dental Group Of Evergreen is 1619774528. It was assigned to this organization in the NPPES registry on February 27, 2025.

Q: What is Pediatric Dental Group Of Evergreen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since February 27, 2025

30960 STAGECOACH BLVD STE W100, EVERGREEN, CO 80439(303) 670-7070(303) 670-7071 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Pediatric Dental Group Of Evergreen NPPES

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

PEDIATRIC DENTAL GROUP OF EVERGREEN (NPI 1619774528) is a healthcare organization registered as a pediatric dentistry in Evergreen, Colorado and active in the NPI registry since February 2025. The organization lists David M Strange, Owner, as its authorized official.

NPPES Registry Identity

NPI1619774528

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePEDIATRIC DENTAL GROUP OF EVERGREEN

Location Address30960 STAGECOACH BLVD STE W100Evergreen, CO 80439-7902

Mailing Address15053 W 55th DrGolden, CO 80403-2923 · (303) 421-5437 · Fax (303) 422-5300

Phone(303) 670-7070

Fax(303) 670-7071

Organization SubpartNo

Authorized OfficialDavid M StrangeOwner · (303) 588-7575

Enumeration DateFebruary 27, 2025

NPPES CertifiedFebruary 27, 2025

✔ NPI 1619774528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

30960 STAGECOACH BLVD STE W100, Evergreen, CO 80439

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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.

DR. JOHN MICHAEL DURUSSEL DDS, MS

Dentist (Orthodontics and Dentofacial Orthopedics)

30960 STAGECOACH BLVD STE W100
EVERGREEN, CO 80439

Jefferson County (303) 674-1122

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 Pediatric Dental Group Of Evergreen's NPI number?

The NPI number for Pediatric Dental Group Of Evergreen is 1619774528. It was assigned to this organization in the NPPES registry on February 27, 2025.

Where is Pediatric Dental Group Of Evergreen located?

Pediatric Dental Group Of Evergreen is located at 30960 Stagecoach Blvd Ste W100, Evergreen, CO 80439. The listed phone number is (303) 670-7070.

What is Pediatric Dental Group Of Evergreen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Pediatric Dental Group Of Evergreen was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.