Individual provider Active NPI

Tamara Kapetanovic, DMD

  • Dentist
  • Westminster, CO
National Provider Identifier
1396586319
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00205964 Issued in CO
Practice address
14422 Orchard Pkwy # 200
Westminster, CO 80023-9272
Phone
(303) 452-0811
NPI assigned
Jun 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00205964 CO Primary

Addresses

Primary practice location

14422 Orchard Pkwy # 200
Westminster, CO 80023-9272

Mailing address

1890 Millstone CT
Alpharetta, GA 30004-7424
Phone (404) 512-5258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241017003900 TX Order and Referring Only - DentistPractitioner - Dentist 9436681236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00205964COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1396586319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 MILLSTONE CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047424",
            "telephone_number": "404-512-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14422 ORCHARD PKWY # 200",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800239272",
            "telephone_number": "303-452-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPETANOVIC",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00205964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.