Colin Boswell, DDS
Individual provider Active NPI Pediatric Dentistry · Shawnee Mission, KS
NPI 1124486675 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124486675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 61356 (KS)
- Practice address
- 9119 W 74TH St Ste 210
Shawnee Mission, KS 66204-2229 - Phone
- (913) 648-2266
- Fax
- (913) 768-1944
- NPI assigned
- Jan 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201014003620 | VT | Order and Referring Only - Dentist |
6002236916 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61356 | KS | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montshire Sanford PC | Pediatric Dentistry | Current | Accepting new patients |
| Montshire Amherst PC | Pediatric Dentistry | Current | Accepting new patients |
Locations
103 Ponemah Rd
Amherst, NH 03031
Phone (603) 451-1479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 61356 | KS | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry |
1223P0221X | 61356 | KS | Yes |
Addresses
Primary practice location
9119 W 74TH St Ste 210
Shawnee Mission, KS 66204-2229
Mailing address
4980 Nottingham Way
Anchorage, AK 99503-6934
Phone (641) 780-7792
Other practice location 1
407 S Clairborne Rd Ste 104
Olathe, KS 66062-1744
Phone (913) 648-2266
Other providers in Shawnee Mission, KS
- Bethesda Lutheran Communities
- Michael J Bevers
- Shannon N. Blatny
- Jamie M Boatman
- Kay Bollinger
- Brandon Michael Bowers
- Danielle Renee Boxberger
- Darren Amundsen Boyack
- John Steven Bradley
- Mark D. Brady
All providers in Shawnee Mission, KS · Pediatric Dentistry in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.