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

Michael Anthony Derose

Individual provider General Practice Dentistry · NPI 1033185871

Michael Anthony Derose is a General Practice Dentistry in Pueblo, Colorado. Licensed in Colorado, Indiana, Kansas and New Mexico and 1 more. Registered with an NPI since 2006.

Licensed in
CO, IN, KS, NM, OK
In the registry since
2006
Specialties on file
5

Practice location Address checks out

1022 Liberty Ln
Pueblo, CO 81001-2039
Phone: (719) 545-5778
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DEN-5133 (CO)
General Practice Dentistry Taxonomy 1223G0001X · Licence 12010424A (IN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 5643 (OK)
General Practice Dentistry Taxonomy 1223G0001X · Licence DD2030 (NM)
General Practice Dentistry Taxonomy 1223G0001X · Licence 60184 (KS)

Record details

NPI number1033185871
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 23, 2006
Last updated in NPPESJuly 13, 2026
Mailing address415 N Grand Ave, Pueblo, CO 81003-3111

Other providers in Pueblo