Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dermatology and Endocrinology LLC

Organization Dermatology Physician · NPI 1114999018

Dermatology and Endocrinology LLC provides Dermatology Physician services in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2006.

Licensed in
CO
In the registry since
2006
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1925 E Orman Ave Ste 115
Pueblo, CO 81004-3500 Not confirmed with CMS for 10 years — call before visiting
Phone: (719) 564-4500
Fax: (719) 564-0304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 26083 (CO)
Endocrinology, Diabetes & Metabolism Physician Taxonomy 207RE0101X · Licence 26084 (CO)

Record details

NPI number1114999018
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kim Dernovsek — Owner · (719) 564-4500
NPI enumeratedFebruary 3, 2006
Last updated in NPPESJanuary 11, 2016
Mailing address1925 E Orman Ave, Ste 115, Pueblo, CO 81004-3537

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