Active NPI
Jeremy G Cardon, D.M.D.
- Dentist
- Castle Rock, CO
National Provider Identifier
1053577130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN.00202126
- Practice address
- 718 Maleta LN
Ste 102
Castle Rock, CO 80108-7602 - Phone
- (303) 814-9899
- NPI assigned
- Jul 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE60034302 | WA | |
| Dentist | 122300000X | DD3475 | NM | |
| Dentist | 122300000X | DEN.00202126 | CO | Primary |
Addresses
Primary practice location
718 Maleta LN
Ste 102
Castle Rock, CO 80108-7602
Mailing address
718 Maleta LN
Ste 102
Castle Rock, CO 80108-7602
Phone (303) 814-9899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE60034302 | Other | WA | WASHINGTON STATE DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00202126 | CO | MD | Dentist |
| DD3475 | NM | MD | Dentist |
| DE60034302 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeremy G Cardon DMD | Dentist | Current | Accepting new patients |
Locations
718 Maleta Ln
Ste 102
Castle Rock, CO 80108
Phone (303) 814-9899
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387411200000",
"number": "1053577130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 MALETA LN",
"address_2": "STE 102",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801087602",
"telephone_number": "303-814-9899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 MALETA LN",
"address_2": "STE 102",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801087602",
"telephone_number": "303-814-9899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDON",
"first_name": "JEREMY",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-29",
"last_updated": "2013-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE60034302",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3475",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00202126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DENTAL LICENSE",
"identifier": "DE60034302",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Castle Rock, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.