Individual provider Active NPI

Kurt E Nielsen, D.D.S.

  • General Practice Dentistry
  • Centennial, CO
National Provider Identifier
1295933059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7790 Issued in CO
Practice address
8010 S Holly St Ste 100
Centennial, CO 80122-4011
Phone
(303) 694-6400
Fax
(303) 694-0551
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

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 7790 CO Primary

Addresses

Primary practice location

8010 S Holly St Ste 100
Centennial, CO 80122-4011

Mailing address

8010 S Holly St Ste 100
Centennial, CO 80122-4011
Phone (303) 694-6400

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
I20160613000964 CO Order and Referring Only - DentistPractitioner - Dentist 7517257074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7790COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Dental Associates General Practice 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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295933059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 S HOLLY ST STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801224011",
            "telephone_number": "303-694-6400",
            "fax_number": "303-694-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 S HOLLY ST STE 100",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801224011",
            "telephone_number": "303-694-6400",
            "fax_number": "303-694-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KURT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.