Individual provider Active NPI

Colton Alexander Lynn Allen, DDS

  • Dentist
  • Lincoln, NE
National Provider Identifier
1124696612
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1617 Issued in WY
Practice address
4000 E Campus Loop S
Lincoln, NE 68583-1530
Phone
(402) 472-1333
NPI assigned
Jun 11, 2021
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8014 NE
Dentist 122300000X 1617 WY Primary

Addresses

Primary practice location

4000 E Campus Loop S
Lincoln, NE 68583-1530

Mailing address

4000 E Campus Loop S
Lincoln, NE 68583-1530
Phone (307) 640-4665

Other practice location 1

3501 Gaston Way Unit A
Greenville, NC 27834-2172
Phone (307) 640-4665

Other practice location 2

1530 Centennial Ct Ste A
Casper, WY 82609-7304
Phone (307) 885-1258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20230801004368 WY Practitioner - Dentist 4385000603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Speech and Hearing Clinic CurrentSince Jun 5, 2023 Accepting new patients
University of Wyoming CurrentSince Jun 5, 2023 Accepting new patients
University of Wyoming Past Accepting new patients
Unmc College of Dentistry Dentist PastSince Jul 21, 2024 Accepting new patients

Locations

1522 E A St
Casper, WY 82601
Phone (307) 233-6000

820 E 17th St
Cheyenne, WY 82001
Phone (307) 431-5055

2710 Harney St
Ste 202
Laramie, WY 82072
Phone (307) 742-3242

Interoperability endpoints

  • Direct secure messaging: colton.allen.1@30244.direct.athenahealth.com

Organizations & group practices 4

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": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1124696612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 E CAMPUS LOOP S",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685831530",
            "telephone_number": "307-640-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 E CAMPUS LOOP S",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685831530",
            "telephone_number": "402-472-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Gaston Way Unit A",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342172",
            "country_code": "US",
            "telephone_number": "307-640-4665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1530 Centennial Ct Ste A",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826097304",
            "country_code": "US",
            "telephone_number": "307-885-1258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "COLTON",
        "middle_name": "ALEXANDER LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "8014",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.