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

Divine Dermatology and Surgical Institute, PLLC

Organization Dermatology Physician · NPI 1962164269

Divine Dermatology and Surgical Institute, PLLC is a Dermatology Physician in Longmont, Colorado. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1715 Iron Horse Dr Ste 104
Longmont, CO 80501-9756
Phone: (970) 286-2668
Fax: (970) 294-4954
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1962164269
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationDivine Dermatology and Surgical Institue, PLLC
Authorized official Jennifer Divine — Owner · (970) 286-2668
Other names Divine Dermatology
NPI enumeratedOctober 13, 2021
Last updated in NPPESOctober 13, 2021
Certification dateOctober 13, 2021
Mailing address1260 Doctors Ln Ste A, Fort Collins, CO 80524-4072

Other providers in Longmont