Active NPI
Kory Joseph Carpenter, DDS
- Dentist
- Buckley Afb, CO
National Provider Identifier
1548998388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN.00205196
- Practice address
- 275 South Aspen St, Stop 89
460 MDG
Buckley Afb, CO 80011 - Phone
- (720) 847-4118
- NPI assigned
- Aug 10, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00205196 | CO | Primary |
Addresses
Primary practice location
275 South Aspen St, Stop 89
460 MDG
Buckley Afb, CO 80011
Mailing address
275 South Aspen St, Stop 89
460 MDG
Buckley Afb, CO 80011
Phone (720) 847-4118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DEN.00205196 | Other | CO | COLORADO DENTAL BOARD |
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 |
|---|---|---|---|
| DEN.00205196 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1548998388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 SOUTH ASPEN ST, STOP 89",
"address_2": "460 MDG",
"city": "BUCKLEY AFB",
"state": "CO",
"postal_code": "80011",
"telephone_number": "720-847-4118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 SOUTH ASPEN ST, STOP 89",
"address_2": "460 MDG",
"city": "BUCKLEY AFB",
"state": "CO",
"postal_code": "80011",
"telephone_number": "720-847-4118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "KORY",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-10",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00205196",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO DENTAL BOARD",
"identifier": "DEN.00205196",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buckley Afb, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.