NPIMap

Organization Active NPI

Castle Rock Oral and Maxillofacial Surgery, PC

Doing business as Castle Rock Oral and Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Castle Rock, CO
National Provider Identifier
1508146630
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
10214 Issued in CO
Legal business name
CASTLE ROCK ORAL AND MAXILLOFACIAL SURGERY, PC
Doing business as
Castle Rock Oral and Facial Surgery
Practice address
2352 Meadows Blvd
205
Castle Rock, CO 80109-8406
Phone
(303) 663-7890
Fax
(888) 765-9130
NPI assigned
Aug 20, 2011
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Dr. Kristopher Larkin Hart, DDSNPI 1811960388
Title
President
Phone
(254) 449-6581

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 10214 CO
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 21512 TX
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X 10214 CO Primary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X 21512 TX

Addresses

Primary practice location

2352 Meadows Blvd
205
Castle Rock, CO 80109-8406

Mailing address

2352 Meadows Blvd
205
Castle Rock, CO 80109-8406
Phone (303) 663-7890

Other names 1

  • Castle Rock Oral and Facial Surgery Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1313798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1508146630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 MEADOWS BLVD",
            "address_2": "205",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098406",
            "telephone_number": "303-663-7890",
            "fax_number": "888-765-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 MEADOWS BLVD",
            "address_2": "205",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098406",
            "telephone_number": "303-663-7890",
            "fax_number": "888-765-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE ROCK ORAL AND MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-20",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "LARKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-449-6581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "10214",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21512",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CO",
            "license": "10214",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "21512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Castle Rock Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.