Kathryn Dickmann, DDS
Individual provider Active NPI General Practice Dentistry · Superior, CO
NPI 1013430347 · NPPES record last updated Jul 18, 2017
Key facts
- NPI
- 1013430347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DEN.0020325 (CO)
- Practice address
- 306 Center Dr
Superior, CO 80027-8625 - Phone
- (303) 499-9555
- NPI assigned
- Jul 18, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.0020325 | CO | MD | General Practice Dentistry |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marketplace Dental Group and Orthodontics, LLP | General Practice | Past | Accepting new patients |
Networks
- NM HMO C-SNP
- CO HMO D-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN.0020325 | CO | Yes |
Addresses
Primary practice location
306 Center Dr
Superior, CO 80027-8625
Mailing address
11994 Ridge Pkwy Apt 201
Broomfield, CO 80021-5158
Other providers in Superior, CO
- Emily Deardorff
- Suzanne Rene Delange
- Emily Deleon
- Denver Eye Care Specialists
- Bruce James Dickerhofe
- Kevin Doherty
- Dawa Dolma
- Harma A Drenth
- Dudleysuperior PLLC
- Jocelyn Duff
All providers in Superior, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.