Individual provider Active NPI

Duane Andrew Kelson, DDS

  • General Practice Dentistry
  • Longmont, CO
National Provider Identifier
1275645293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9159 Issued in CO
Practice address
600 S Airport Rd Ste 200
Longmont, CO 80503-6427
Phone
(303) 776-3320
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 9159 CO Primary

Addresses

Primary practice location

600 S Airport Rd Ste 200
Longmont, CO 80503-6427

Mailing address

600 S Airport Rd Ste 200
Longmont, CO 80503-6427
Phone (303) 776-3320

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
I20190122000883 CO Order and Referring Only - DentistPractitioner - Dentist 2769729334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9159COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Horizons PC 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.

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": "1183852800000",
    "number": "1275645293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S AIRPORT RD STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036427",
            "telephone_number": "303-776-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S AIRPORT RD STE 200",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036427",
            "telephone_number": "303-776-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSON",
        "first_name": "DUANE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.