MEDICARE: JUST FOR GRINS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8170	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205028941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUST FOR GRINS LLC

Provider Business Mailing Address
First Line	:	6436 S US HIGHWAY 85-87
Second Line	:	SUITE C
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-1005
Country	:	US
Telephone Number	:	719-392-5111
Fax Number	:	719-392-4143

Provider Business Practice Location Address
First Line	:	6436 S US HIGHWAY 85-87
Second Line	:	SUITE C
City	:	FOUNTAIN
State	:	CO
Zip	:	80817
Country	:	US
Telephone Number	:	719-392-5111
Fax Number	:	719-392-4143

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	DOMINIQUE PACHECO
Credential	:
Telephone Number	:	719-392-5111

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	01/15/2026

Similar Medicare Providers

1669330379 — ZACHERY PHILLIPS
Practice Location Address:

901 N SANTA FE AVE
FOUNTAIN, CO
80817-1738

Practice Phone: 719-822-0550
Practice Fax:

1205541802 — SAMANTHA MCDONAGH RDH
Practice Location Address:

6436 S US HIGHWAY 85-87 STE C
FOUNTAIN, CO
80817-1005

Practice Phone: 719-392-5111
Practice Fax:

1912012279 — DR. JOE FRANK MALTSBERGER DDS
Practice Location Address:

6980 MESA RIDGE PKWY STE 200
FOUNTAIN, CO
80817-1563

Practice Phone: 918-230-4789
Practice Fax:

1154287043 — PAUL GUTIERREZ
Practice Location Address:

901 N SANTA FE AVE
FOUNTAIN, CO
80817-1738

Practice Phone: 719-347-8201
Practice Fax:

1841157476 — ANDREW EDWARD JIMENEZ
Practice Location Address:

6436 S US HIGHWAY 85-87 STE U
FOUNTAIN, CO
80817-1007

Practice Phone: 719-822-0460
Practice Fax:

1194419127 — DR. CATHERINE ANN MROCHINSKI PT, DPT
Practice Location Address:

6980 MESA RIDGE PKWY
FOUNTAIN, CO
80817-1563

Practice Phone: 414-702-9218
Practice Fax:

Directions to “JUST FOR GRINS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.