Individual provider Active NPI

Summer Marie Kassmel, DDS

  • Dentist
  • Eagle, CO
National Provider Identifier
1578766978
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8477 Issued in CO
Practice address
56 Market Street
Suite 5
Eagle, CO 81631
Phone
(970) 328-1116
Fax
(970) 328-0524
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8477 CO Primary

Addresses

Primary practice location

56 Market Street
Suite 5
Eagle, CO 81631

Mailing address

PO Box 576
56 Market Street Suite 5
Eagle, CO 81631
Phone (970) 328-1116

Other names 1

  • Summer Marie Smith Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191021000639 CO Order and Referring Only - DentistPractitioner - Dentist 8123359304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8477COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1578766978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "address_2": "56 MARKET STREET SUITE 5",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "81631",
            "telephone_number": "970-328-1116",
            "fax_number": "970-328-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 MARKET STREET",
            "address_2": "SUITE 5",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "81631",
            "telephone_number": "970-328-1116",
            "fax_number": "970-328-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSMEL",
        "first_name": "SUMMER",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUMMER",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eagle, CO

Sources for this page

Verify at the official NPI Registry.