Zachary Alex Kettler, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

203266 Issued in CO

Practice address

250 Max Dr Ste 202
Castle Pines, CO 80108-9519

Phone

(720) 733-7799

NPI assigned

Jul 18, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Professional Dental Care of Central Colorado I PLLC

  • Dental Clinic/Center
  • Parker, CO
  • NPI 1790394138
  NPD
• Northglenn Smiles Dentistry and Orthodontics, LLP

  • General Practice Dentistry
  • Northglenn, CO
  • NPI 1992115497
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1063935385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MAX DR STE 202",
            "city": "CASTLE PINES",
            "state": "CO",
            "postal_code": "801089519",
            "telephone_number": "720-733-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAX DR STE 202",
            "city": "CASTLE PINES",
            "state": "CO",
            "postal_code": "801089519",
            "telephone_number": "720-733-7799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4490 W 121st Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800205603",
            "country_code": "US",
            "telephone_number": "303-469-2061",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E 120th Ave Unit C130",
            "address_purpose": "LOCATION",
            "city": "Northglenn",
            "state": "CO",
            "postal_code": "802335740",
            "country_code": "US",
            "telephone_number": "720-977-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13097 S Parker Rd Unit A",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801347447",
            "country_code": "US",
            "telephone_number": "303-887-8848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETTLER",
        "first_name": "ZACHARY",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "203266",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immersiv Health of Colorado, PLLC
• In the Shelter LLC
• Michelle M Jaeger, RDN
• Jogan Health, LLC
• Jonathan D Sierk, DDS, PC
• Kids Tooth Doc
• Katie Ann Kostelyk, MA,LPC, LAC
• Alex Krasovec
• Nicholas James Krebs, M.D.
• Carrie Lafleur

• Dentist in Castle Pines, CO
• Providers in Castle Pines, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.