Individual provider Active NPI

Steven L Klyn, DDS

  • Endodontics
  • Usaf Academy, CO
National Provider Identifier
1285617555
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
07448 Issued in IA
Practice address
4102 Pinion Dr Ste 100
10 MDG
Usaf Academy, CO 80840-2502
Phone
(719) 333-5962
Fax
(719) 333-5268
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 07448 IA
Endodontics 1223E0200X 07448 IA Primary

Addresses

Primary practice location

4102 Pinion Dr Ste 100
10 MDG
Usaf Academy, CO 80840-2502

Mailing address

4102 Pinion Dr Ste 100
10 MDG
Usaf Academy, CO 80840-2502
Phone (719) 333-5962

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

LicenseStateTypeSpecialty
07448IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1285617555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR STE 100",
            "address_2": "10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5962",
            "fax_number": "719-333-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR STE 100",
            "address_2": "10 MDG",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5962",
            "fax_number": "719-333-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLYN",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07448",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "07448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.