Kelly Renee Freeman, DDS
Individual provider Active NPI General Practice Dentistry · Lonetree, CO
NPI 1487988259 · NPPES record last updated Sep 28, 2009
Key facts
- NPI
- 1487988259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9957 (CO)
- Practice address
- 10455 Park Meadows Dr
Suite 101
Lonetree, CO 80124-5599 - Phone
- (303) 521-5658
- NPI assigned
- Sep 28, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 10, 2016 through Oct 10, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9957 | CO | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9957 | CO | Yes |
Addresses
Primary practice location
10455 Park Meadows Dr
Suite 101
Lonetree, CO 80124-5599
Mailing address
16131 E Otero Ave
Englewood, CO 80112-4623
Phone (303) 521-5658
Other providers in Lonetree, CO
- Denver Spine Center
- Jennifer T Desbois
- Amy M Diruzzo
- Brenda C Eiser
- Rachael Falkowitz
- Jennifer Freezer
- Wayne Charles Furr
- Alan Keith Garner
- Annie Giang
- Gregory a Justice DC, PC
All providers in Lonetree, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.