Individual provider Active NPI

Ralph Fridolin Parkin, DMD

  • Dentist
  • Colorado Springs, CO
National Provider Identifier
1205943172
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104559 Issued in CO
Practice address
1803 B Street
Colorado Springs, CO 80906
Phone
(719) 576-1730
Fax
(719) 576-3456
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 104559 CO Primary

Addresses

Primary practice location

1803 B Street
Colorado Springs, CO 80906

Mailing address

1803 B Street
Colorado Springs, CO 80906
Phone (719) 576-1730

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
I20160121001065 CO Order and Referring Only - DentistPractitioner - Dentist 3577866730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104559COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205943172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 B STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-576-1730",
            "fax_number": "719-576-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 B STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80906",
            "telephone_number": "719-576-1730",
            "fax_number": "719-576-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKIN",
        "first_name": "RALPH",
        "middle_name": "FRIDOLIN",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "104559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.