Healthcare Provider Details

I. General information

NPI: 1689483216
Provider Name (Legal Business Name): DINOMITE SMILES PEDIATRIC DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 MAIN ST # A101
MEAD CO
80542-5030
US

IV. Provider business mailing address

234 MAIN STREET A101 PO BOX 158
MEAD CO
80542
US

V. Phone/Fax

Practice location:
  • Phone: 720-677-0018
  • Fax:
Mailing address:
  • Phone: 720-677-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE FERRAIOLI
Title or Position: DENTIST
Credential: DDS
Phone: 720-677-0018