Individual provider Active NPI

Kimberly Marshall, DDS

  • General Practice Dentistry
  • Aurora, CO
National Provider Identifier
1386782423
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8641 Issued in CO
Practice address
1635 Ursula St
RM 5200
Aurora, CO 80045-7402
Phone
(720) 848-0687
Fax
(720) 848-0660
NPI assigned
Feb 1, 2007
Sex
Female
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 8641 CO Primary

Addresses

Primary practice location

1635 Ursula St
RM 5200
Aurora, CO 80045-7402

Mailing address

PO Box 6510
Mail Stop F742
Aurora, CO 80045-0510
Phone (720) 848-0687

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
I20151029000989 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042529216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8641COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386782423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6510",
            "address_2": "MAIL STOP F742",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800450510",
            "telephone_number": "720-848-0687",
            "fax_number": "720-848-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 URSULA ST",
            "address_2": "RM 5200",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457402",
            "telephone_number": "720-848-0687",
            "fax_number": "720-848-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.