Individual provider Active NPI

Kendall Robert Burns III, DMD

  • Dentist
  • Broomfield, CO
National Provider Identifier
1366476434
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8591 Issued in CO
Practice address
3305 W 144TH Avenue
Unit 100
Broomfield, CO 80023
Phone
(303) 460-8700
Fax
(303) 648-6055
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 8591 CO
Dentist 122300000X 8591 CO Primary

Addresses

Primary practice location

3305 W 144TH Avenue
Unit 100
Broomfield, CO 80023

Mailing address

3305 W 144TH Ave Unit 100
Broomfield, CO 80023-9483
Phone (303) 460-8700

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
8591COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlands Family Dentistry General Partnership Dentist CurrentSince Jan 12, 2025 Accepting new patients

Locations

3305 W 144th Ave
Unit 100
Broomfield, CO 80023
Phone (303) 460-8700

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1366476434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 W 144TH AVE UNIT 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800239483",
            "telephone_number": "303-460-8700",
            "fax_number": "303-648-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 W 144TH AVENUE",
            "address_2": "UNIT 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "80023",
            "telephone_number": "303-460-8700",
            "fax_number": "303-648-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "KENDALL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-01-08",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8591",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.