Mackenzie Kathleen Schumborg, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00204470 Issued in CO

Practice address

9625 Prominent PT Ste 100
Colorado Springs, CO 80924-5005

Phone

(719) 495-5748

NPI assigned

Aug 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Prominent Point Dental Group and Orthodontics, LLP

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1700020104
  NPD (past)

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1417567694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 RAYWOOD VW APT 221",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207741",
            "telephone_number": "734-474-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 PROMINENT PT STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809245005",
            "telephone_number": "719-495-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUMBORG",
        "first_name": "MACKENZIE",
        "middle_name": "KATHLEEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Schulze
• Michelle Alison Schulze, MS,PT
• John Schumacher
• Christian E Schumann, PHARMD
• Kristin Elizabeth Schumann, DPT
• Ross Aron Schumer, MD
• Maggie Elayne Schumm, FNP-BC
• Michael Schuneman, D.C.
• Heather Schunke
• Lindsay M Schustedt

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.