Keith I. Wilken, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401417729 Issued in VA

Practice address

7600 W US Highway 50
Salida, CO 81201-9344

Phone

(719) 539-2587

Fax

(719) 539-4169

NPI assigned

Apr 3, 2007

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kuumba Community Health & Wellness Center, Inc.

  dba New Horizons Healthcare

  • Federally Qualified Health Center (FQHC)
  • Roanoke, VA
  • NPI 1205815420
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1538280516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 W US HIGHWAY 50",
            "city": "SALIDA",
            "state": "CO",
            "postal_code": "812019344",
            "telephone_number": "719-539-2587",
            "fax_number": "719-539-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKEN",
        "first_name": "KEITH",
        "middle_name": "I.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "4375",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02073757",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwilken143599@direct.carilionclinic.org",
            "affiliation": "N",
            "address_1": "1111 S Jefferson St",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Whitman, FNP
• Cole Anthony Wiedel
• John Wierdsma, D.O.
• James G Wigington, M.D.
• Wild Roots Therapeutics
• Tricia Rose Wilkins, PHARMD
• Sommer Williams, BSN, RN, IBCLC
• Womens Health and Wellness of Salida
• Matthew Tyler Wood
• Karry Wooddell, MT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.