Individual provider Active NPI

Kent William Stilson, DDS

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1053710087
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00202336 Issued in CO
Practice address
9680 Nautilus PT
Colorado Springs, CO 80924-8706
Phone
(791) 494-2865
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00202336 CO Primary

Addresses

Primary practice location

9680 Nautilus PT
Colorado Springs, CO 80924-8706

Mailing address

9680 Nautilus PT
Colorado Springs, CO 80924-8706
Phone (791) 494-2865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728004404 CO Order and Referring Only - DentistPractitioner - Dentist 9032423512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00202336COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
North Powers Modern Dentistry, LLP Past Accepting new patients
Egbert and Stilson Dental PLLC Dentist PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 2

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1053710087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9680 NAUTILUS PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809248706",
            "telephone_number": "791-494-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9680 NAUTILUS PT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809248706",
            "telephone_number": "791-494-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILSON",
        "first_name": "KENT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.