Individual provider Active NPI

Susan H Hickerson-Kurtz, DDS

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1205845435
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7458 Issued in CO
Practice address
300 S Jackson St Ste 510
Denver, CO 80209-3133
Phone
(303) 388-5222
Fax
(303) 394-9670
NPI assigned
Aug 5, 2006
Last updated
Aug 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7458 CO Primary

Addresses

Primary practice location

300 S Jackson St Ste 510
Denver, CO 80209-3133

Mailing address

300 S Jackson St Ste 510
Denver, CO 80209-3133
Phone (303) 388-5222

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
I20160809000448 CO Order and Referring Only - DentistPractitioner - Dentist 8325332760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7458COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1205845435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093133",
            "telephone_number": "303-388-5222",
            "fax_number": "303-394-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST STE 510",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093133",
            "telephone_number": "303-388-5222",
            "fax_number": "303-394-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON-KURTZ",
        "first_name": "SUSAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.