Colorado Kids Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8330 Issued in CO

Legal business name

COLORADO KIDS PEDIATRIC DENTISTRY

Practice address

9227 E Lincoln Ave Ste 100
Lone Tree, CO 80124-5504

Phone

(303) 225-4715

Fax

(303) 688-6012

NPI assigned

Jan 25, 2007

Organization subpart

Yes

Parent organization

COLORADO KIDS PEDIATRIC DENTISTRYAs reported in NPPES

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

Authorized official

Name

Dr. Lisa Mehelich Fox, DDS

Title

Owner/Operator

Phone

(303) 791-4400

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Drs. Fox, Waguespack & Norwood Doing business as

Tax ID family

Colorado Kids Pediatric Dentistry2 organizations share this tax ID, including this one

Part of

Colorado Kids Pediatric Dentistry

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Colorado Kids Pediatric Dentistry

  • Pediatric Dentistry
  • Highlands Ranch, CO
  • NPI 1619976990
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Colorado Kids Pediatric Dentistry

  • Pediatric Dentistry
  • Highlands Ranch, CO
  • NPI 1619976990
  NPPES parent name

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1407901754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9227 E LINCOLN AVE STE 100",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245504",
            "telephone_number": "303-225-4715",
            "fax_number": "303-688-6012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9227 E LINCOLN AVE STE 100",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245504",
            "telephone_number": "303-225-4715",
            "fax_number": "303-688-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO KIDS PEDIATRIC DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLORADO KIDS PEDIATRIC DENTISTRY",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MEHELICH",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "303-791-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "8330",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "00201980",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KATHLEEN E. WAGUESPACK, DMD NPI",
            "identifier": "1215048806",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISA MEHELICH FOX, DDS NPI",
            "identifier": "1427078435",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Fox, Waguespack & Norwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Drs. Fox, Waguespack & Norwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.