Individual provider Active NPI

Kevin J. Wright, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Colorado Springs, CO
National Provider Identifier
1376863845
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
00202234 Issued in CO
Practice address
595 Chapel Hills Dr
Suite 300
Colorado Springs, CO 80920-1022
Phone
(719) 599-0500
Fax
(719) 599-0575
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 00202234 CO Primary

Addresses

Primary practice location

595 Chapel Hills Dr
Suite 300
Colorado Springs, CO 80920-1022

Mailing address

595 Chapel Hills Dr
Suite 300
Colorado Springs, CO 80920-1022
Phone (719) 599-0500

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
I20150211000642 CO Practitioner - Oral Surgery 0042431421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Virginia Commonwealth Univ School of Dentistry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Maxillofacial and Oral Surgery PLLCGroup PAC ID 0446790430, 3 clinicians

Practice addresses (Care Compare)

10219 Parkglenn Way
Suite 201
Parker, CO 80138-3875
Phone (303) 217-8017

320 E Fontanero St
Suite 200
Colorado Springs, CO 80907-7525
Phone (719) 599-0500

755 Maleta LN
Suite a
Castle Rock, CO 80108-7610
Phone (303) 217-8017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00202234COMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Maxillofacial and Oral Surgery, PLLC Oral and Maxillofacial Surgery CurrentSince Aug 1, 2024 Accepting new patients
Associates in Maxillofacial and Oral Surgery, PLLC Oral and Maxillofacial Surgery CurrentSince Aug 1, 2024 Accepting new patients

Locations

111 N 10th St
Canon City, CO 81212

755 Maleta Ln
Ste A
Castle Rock, CO 80108
Phone (303) 217-8017

1755 Telstar Dr
Ste 210
Colorado Springs, CO 80920
Phone 71930059331011

320 E Fontanero St
Ste 200
Colorado Springs, CO 80907
Phone (718) 471-0080

10219 Parkglenn Way
Ste 201
Parker, CO 80138
Phone (303) 217-8017

Organizations & group practices 2

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1376863845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022",
            "telephone_number": "719-599-0500",
            "fax_number": "719-599-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR",
            "address_2": "SUITE 300",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022",
            "telephone_number": "719-599-0500",
            "fax_number": "719-599-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "00202234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.