Active NPI
Kristy Dhaliwal, D.D.S.
- General Practice Dentistry
- Boulder, CO
National Provider Identifier
1295902401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8183
- Practice address
- 1001 North St
Boulder, CO 80304-3308 - Phone
- (303) 447-1042
- NPI assigned
- May 15, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8183 | CO | Primary |
Addresses
Primary practice location
1001 North St
Boulder, CO 80304-3308
Mailing address
166 S Cedar Brook Rd
Boulder, CO 80304-0468
Phone (303) 473-0541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 25, 2017 through Apr 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8183 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1295902401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 S CEDAR BROOK RD",
"city": "BOULDER",
"state": "CO",
"postal_code": "803040468",
"telephone_number": "303-473-0541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 NORTH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803043308",
"telephone_number": "303-447-1042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHALIWAL",
"first_name": "KRISTY",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-15",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "8183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.