Healthcare Provider Details

I. General information

NPI: 1467102764
Provider Name (Legal Business Name): DOMINIC FRANK DAMIEN RAGO MD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 28TH ST
DENVER CO
80205-3003
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-6333
  • Fax:
Mailing address:
  • Phone: 303-602-6333
  • Fax: 303-436-4665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0075603
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: