DEROSE CHILDREN'S DENTAL CLINIC, PC
NPI 1699724831
Dentist - General Practice in Pueblo, CO

Q: What is Derose Children's Dental Clinic, PC's NPI number?

The NPI number for Derose Children's Dental Clinic, PC is 1699724831. It was assigned to this organization in the NPPES registry on May 7, 2006.

Q: What is Derose Children's Dental Clinic, PC's specialty?

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

Active since May 07, 2006

1022 LIBERTY LN, PUEBLO, CO 81001(719) 545-5775 Get Directions Write a Review

NPPES record last updated: May 17, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Derose Children's Dental Clinic, Pc NPPES

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

DEROSE CHILDREN'S DENTAL CLINIC, PC (NPI 1699724831) is a healthcare organization registered as a general practice in Pueblo, Colorado and active in the NPI registry since May 2006. The organization lists Trudy Williams, Director, Licensing & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1699724831

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameDEROSE CHILDREN'S DENTAL CLINIC, PC

Location Address1022 LIBERTY LNPueblo, CO 81001-2039

Mailing Address201 W 8th St, Suite 810Pueblo, CO 81003-3038 · (719) 562-4447

Phone(719) 545-5775

Organization SubpartNo

Authorized OfficialTrudy WilliamsDirector, Licensing & Credentialing · (615) 750-0342

Enumeration DateMay 7, 2006

Last NPPES UpdateMay 17, 2010

✔ NPI 1699724831 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.

1022 LIBERTY LN, Pueblo, CO 81001

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Other Identifiers 1

Medicaid42852561CO

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 6

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

MICHAEL ANTHONY DEROSE

Dentist (General Practice)