DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC
NPI 1962164269
Dermatology in Longmont, CO

Active since October 13, 2021
1715 IRON HORSE DR STE 104, LONGMONT, CO 80501(970) 286-2668(970) 294-4954 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Divine Dermatology And Surgical Institute, Pllc NPPES

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

DIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC (NPI 1962164269) is a healthcare organization registered as a dermatology in Longmont, Colorado and active in the NPI registry since October 2021. The organization lists Jennifer Michelle Divine, Owner, as its authorized official.

NPPES Registry Identity

NPI1962164269
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDIVINE DERMATOLOGY AND SURGICAL INSTITUTE, PLLC
Location Address1715 IRON HORSE DR STE 104Longmont, CO 80501-9756
Mailing Address1260 Doctors Ln Ste AFort Collins, CO 80524-4072 · (970) 286-2668 · Fax (970) 294-4954
Fax(970) 294-4954
Organization SubpartYesParent: Divine Dermatology And Surgical Institue, Pllc
Authorized OfficialJennifer Michelle DivineOwner · (970) 286-2668
Enumeration DateOctober 13, 2021
NPPES CertifiedOctober 13, 2021
NPI 1962164269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1715 IRON HORSE DR STE 104, Longmont, CO 80501

Other Names 1

Other NameDivine Dermatology

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.

Physician Assistant (Medical)
1715 IRON HORSE DR STE 104
LONGMONT, CO 80501

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 Divine Dermatology And Surgical Institute, PLLC's NPI number?

The NPI number for Divine Dermatology And Surgical Institute, PLLC is 1962164269. It was assigned to this organization in the NPPES registry on October 13, 2021. The provider is also known as Divine Dermatology.

Where is Divine Dermatology And Surgical Institute, PLLC located?

Divine Dermatology And Surgical Institute, PLLC is located at 1715 Iron Horse Dr Ste 104, Longmont, CO 80501. The listed phone number is (970) 286-2668.

What is Divine Dermatology And Surgical Institute, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Divine Dermatology And Surgical Institute, PLLC was last updated on October 13, 2021. 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.