Active NPI
Kristine Douglas, SA
- Dental Assistant
- Englewood, CO
National Provider Identifier
1457945396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- SA.0001606
- Practice address
- 125 Inverness Dr E Ste 100
Englewood, CO 80112-5139 - Phone
- (303) 773-8228
- NPI assigned
- Feb 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | SA.0001606 | CO | Primary |
Addresses
Primary practice location
125 Inverness Dr E Ste 100
Englewood, CO 80112-5139
Mailing address
125 Inverness Dr E Ste 100
Englewood, CO 80112-5139
Phone (303) 773-8228
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA.0001606 | CO | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1457945396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 INVERNESS DR E STE 100",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801125139",
"telephone_number": "303-773-8228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 INVERNESS DR E STE 100",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801125139",
"telephone_number": "303-773-8228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "KRISTINE",
"credential": "SA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-22",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CO",
"license": "SA.0001606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.