Individual provider Active NPI

Adam Dore, DDS

  • Dentist
  • Fountain, CO
National Provider Identifier
1205529468
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00205626 Issued in CO
Practice address
6940 Mesa Ridge Pkwy
Fountain, CO 80817-1533
Phone
(791) 382-4936
NPI assigned
Jun 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00205626 CO Primary

Addresses

Primary practice location

6940 Mesa Ridge Pkwy
Fountain, CO 80817-1533

Mailing address

6940 Mesa Ridge Pkwy
Fountain, CO 80817-1533

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
I20231020001462 CO Order and Referring Only - DentistPractitioner - Dentist 0648626036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00205626COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1205529468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6940 MESA RIDGE PKWY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6940 MESA RIDGE PKWY",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171533",
            "telephone_number": "791-382-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORE",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain, CO

Sources for this page

Verify at the official NPI Registry.