Monty Carl Kingsley, DDS
Individual provider Active NPI Dentist · Brush, CO
NPI 1275734584 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275734584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7376 (CO)
- Practice address
- 242 Cambridge St
Suite 2
Brush, CO 80723-1608 - Phone
- (970) 842-2494
- Fax
- (970) 842-5217
- NPI assigned
- May 31, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7376 | CO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7376 | CO | Yes |
Addresses
Primary practice location
242 Cambridge St
Suite 2
Brush, CO 80723-1608
Mailing address
242 Cambridge St
Suite 2
Brush, CO 80723-1608
Phone (970) 842-2494
Other providers in Brush, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.