Active NPI
Kathleen Elizabeth Waguespack, DMD
- Pediatric Dentistry
- Highlands Ranch, CO
National Provider Identifier
1215048806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN.00201980
- Practice address
- 9358 Dorchester St
Suite 106
Highlands Ranch, CO 80129-5606 - Phone
- (303) 791-4400
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DEN.00201980 | CO | Primary |
Addresses
Primary practice location
9358 Dorchester St
Suite 106
Highlands Ranch, CO 80129-5606
Mailing address
9358 Dorchester St
Suite 106
Highlands Ranch, CO 80129-5606
Phone (303) 791-4400
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 022868 | Medicaid | OR | |
| 943096772 | Other | TAX ID | |
| 25090 | Other | TX | TEXAS BOARD OF DENTAL EXAMINERS |
| D8770 | Other | OR | DENTAL LICENSE |
| DEN.00201980 | Other | CO | DORA |
Other names 1
- Kathleen Elizabeth White
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.00201980 | CO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Kids Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Highlands Ranch, CO
- NPI 1619976990
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1215048806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9358 DORCHESTER ST",
"address_2": "SUITE 106",
"city": "HIGHLANDS RANCH",
"state": "CO",
"postal_code": "801295606",
"telephone_number": "303-791-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9358 DORCHESTER ST",
"address_2": "SUITE 106",
"city": "HIGHLANDS RANCH",
"state": "CO",
"postal_code": "801295606",
"telephone_number": "303-791-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGUESPACK",
"first_name": "KATHLEEN",
"middle_name": "ELIZABETH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00201980",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "022868",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "943096772",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS BOARD OF DENTAL EXAMINERS",
"identifier": "25090",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "D8770",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORA",
"identifier": "DEN.00201980",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "WHITE",
"middle_name": "ELIZABETH",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Highlands Ranch, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.