Adam Kwiatkowski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00204396 Issued in CO

Practice address

1200 28TH St Ste 300
Boulder, CO 80303-1756

Phone

(303) 417-1644

Fax

(303) 417-1790

NPI assigned

Aug 13, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Oral SurgeryAlso: Dentist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peakview Dentistry PLLCGroup PAC ID 8123498250, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Peakview Dentistry PLLC

  dba Peakview Cosmetic & Implant Dentistry

  • General Practice Dentistry
  • Boulder, CO
  • NPI 1164036166
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1568073575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 28TH ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031756",
            "telephone_number": "303-417-1644",
            "fax_number": "303-417-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 28TH ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031756",
            "telephone_number": "303-417-1644",
            "fax_number": "303-417-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00204396",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00204396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Kushlak, D.O.
• Natalia Kushner
• James Travis Kuster, APN
• Jessica Kodi Kuykendall
• Elif Kuzu, DAOM
• Emily Jo Kyburz, MS, OTR
• Kyle N. Daniel DDS PC (Boulder Premier Dentistry)
• L Brian Hersch & Associates a Professional LLC
• Jennifer La Borde
• La Luna Center, LLC

• General Practice Dentistry in Boulder, CO
• Providers in Boulder, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.