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

Destination Dermatology LLC

Organization Procedural Dermatology Physician · NPI 1205368453

Destination Dermatology LLC is a Procedural Dermatology Physician in Frisco, Colorado. Licensed in Colorado. Registered with an NPI since 2017.

Licensed in
CO
In the registry since
2017
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

60 Main St Ste F G & H
Frisco, CO 80443
Phone: (309) 287-1909
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence PA0004388 (CO)
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1205368453
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelly Ballou — Managing Member · (970) 409-4000
Other names Renew Dermatology; Renew Dermatology
NPI enumeratedMarch 28, 2017
Last updated in NPPESJune 16, 2026
Certification dateJune 16, 2026
Mailing address400 N Park Ave, Ste 12-B #1178, Breckenridge, CO 80424

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