Kevin Hertich, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DEN.00203362 Issued in CO

Practice address

12999 W Bowles Dr
Littleton, CO 80127-4641

Phone

(720) 513-1193

NPI assigned

Feb 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

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.

• Brandon R Wilcox DDS PLLC

  dba JP Dental Implants and Sedation

  • General Practice Dentistry
  • Grand Junction, CO
  • NPI 1851988059
  Medicare reassignment NPD

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1083207450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4257 MARIPOSA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802112530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12999 W BOWLES DR",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801274641",
            "telephone_number": "720-513-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTICH",
        "first_name": "KEVIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "DEN.00203362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Herrera
• Caleb Elijah Herrin
• Billy J Herring II, RMT
• Ashley Herrington
• Delicia Nicole Herron
• Gregory Herzberg, DDS
• Kayee Ho Herzberg, DDS
• Jacquelyn Heslep, BCBA
• Milan Hess, DVM
• Kimberly Hettel, NCC, LPC

• Periodontics in Littleton, CO
• Providers in Littleton, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.