Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1902805138 Deactivated / Inactive NPI Male Practitioner

Dr. Andrew Lionel Fiscus , DDS

Dentist - General Practice • Boulder, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Andrew Fiscus has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 19, 2005
NPI Deactivation Date March 20, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Andrew Fiscus, DDS was a registered Dentist - General Practice practicing in Boulder, CO. Throughout an active medical career spanning 1 years, Dr. Fiscus provided care at the practice location at 3400 PENROSE PL until profile deactivation on 2006-03-20.

Practice Location & Contact Primary Location

Practice Address

3400 Penrose Pl
Suite 202

Boulder, CO 803011809

Telephone 3034425748
Fax 3034425749
Associated Practice Facility / Clinic
🏢 Markowitz & Wong Orthodontics Facility NPI 1477766178

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Boulder, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.0 Yrs
State Avg: 18.5 Yrs
Regional Practice Density
101 Specialists

Practicing in Boulder, CO (2613 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CO 8195

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Robert Holden , DDS

Dentist - General Practice

NPI 1194941625

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 3400 PENROSE PL, SUITE 202, BOULDER, CO 803011809 (Tel: 3034425748)

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Updated Business Mailing Address July 08, 2007

Registered at 3400 PENROSE PL, SUITE 202, BOULDER, CO 803011809 (Tel: 3034425748)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ANDREW FISCUS, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #8195 in CO)

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NPI Profile Reactivated April 11, 2006

Record officially reactivated for active practice on April 11, 2006

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NPI Profile Deactivated March 20, 2006

Record deactivated on March 20, 2006

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Initial NPI Registration & Enumeration July 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902805138
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2005
Last Update: July 13, 2026
Deactivation Date: March 20, 2006
Sole Proprietor: No

Mailing Address

3400 Penrose Pl, Suite 202

Boulder, CO 803011809

Phone: 3034425748

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.