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

Timothy David Petty, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699418921

Timothy David Petty, DMD is a Student in an Organized Health Care Education/Training Program in Pueblo, Colorado. Licensed in Colorado and New Mexico. Registered with an NPI since 2022.

Licensed in
CO, NM
In the registry since
2022
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

1800 Fortino Blvd Unit 1
Pueblo, CO 81008-1891
Phone: (719) 545-1400
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.00205534 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NM)

Record details

NPI number1699418921
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 14, 2022
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023
Mailing address2554 S Krameria St, Denver, CO 80222-7139

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