Individual provider Active NPI

Kenneth Billings Allen, D.D.S.

  • General Practice Dentistry
  • Fort Collins, CO
National Provider Identifier
1104829118
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8155 Issued in CO
Practice address
1337 Riverside Ave
Ste 1
Fort Collins, CO 80524-4373
Phone
(970) 221-1658
Fax
(970) 482-7549
NPI assigned
May 23, 2005
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1067 WY
General Practice Dentistry 1223G0001X 8155 CO Primary

Addresses

Primary practice location

1337 Riverside Ave
Ste 1
Fort Collins, CO 80524-4373

Mailing address

2117 Custer Dr
Fort Collins, CO 80525-3684
Phone (970) 221-3700

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
I20160105002223 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4981906195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8155COMDGeneral Practice Dentistry
1067WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth B. Allen, DDS, PC General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1104829118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 CUSTER DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253684",
            "telephone_number": "970-221-3700",
            "fax_number": "970-482-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 RIVERSIDE AVE",
            "address_2": "STE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244373",
            "telephone_number": "970-221-1658",
            "fax_number": "970-482-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KENNETH",
        "middle_name": "BILLINGS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1067",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.