Colorado Oral and Facial Cosmetic Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

COLORADO ORAL AND FACIAL COSMETIC SURGERY, PLLC

Practice address

10535 Park Meadows Blvd Ste 250
Lone Tree, CO 80124-8401

Phone

(303) 381-7101

Fax

(303) 381-7101

NPI assigned

Nov 21, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kayvan Fathimani, DDS FACSNPI 1396040127

Title

Owner

Phone

(303) 381-7101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kayvan Fathimani, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lone Tree, CO
  • NPI 1396040127
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1336914282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 250",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248401",
            "telephone_number": "303-381-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 250",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248401",
            "telephone_number": "303-381-7101",
            "fax_number": "303-381-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO ORAL AND FACIAL COSMETIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "FATHIMANI",
        "authorized_official_first_name": "KAYVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-381-7101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS FACS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colorado Permanente Medical Group, P.C. (Kaiser Permanente Ambulatory Surgical Center Lone Tree)
• Colorado Permanente Medical Group, P.C. (Kaiser Permanente Lone Tree Medical Offices)
• Colorado Permanente Medical Group, P.C. (Kaiser Permanente Lone Tree Urgent Care)

• Oral and Maxillofacial Surgery Clinic/Center in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.