Active NPI
Kurt Ellis, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Denver, CO
National Provider Identifier
1124880331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DEN.00206096
- Practice address
- 660 Bannock St
Denver, CO 80204-4506 - Phone
- (303) 436-6000
- NPI assigned
- Jan 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DEN.00206096 | CO | Primary |
Addresses
Primary practice location
660 Bannock St
Denver, CO 80204-4506
Mailing address
660 Bannock St
Denver, CO 80204-4506
Phone (303) 436-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00206096 | CO | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1124880331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044506",
"telephone_number": "303-436-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 BANNOCK ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802044506",
"telephone_number": "303-436-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "KURT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-24",
"last_updated": "2025-07-15",
"certification_date": "2025-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CO",
"license": "DEN.00206096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.