Kenneth Vaughn Wadsworth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

805 Issued in CO

Practice address

11290 W Alameda Ave
#205
Lakewood, CO 80226-2576

Phone

(303) 985-9850

Fax

(303) 985-5827

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598988339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5088 S PERRY PARK RD",
            "city": "SEDALIA",
            "state": "CO",
            "postal_code": "801358209",
            "telephone_number": "303-681-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11290 W ALAMEDA AVE",
            "address_2": "#205",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802262576",
            "telephone_number": "303-985-9850",
            "fax_number": "303-985-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "KENNETH",
        "middle_name": "VAUGHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W.J. Pontarelli, Jr., D.D.S., P.C.
• Robert Finley Waadt II, LPCC
• Andrew Waas
• Matthew Adam Wachtman, DPT
• James H Wade, OTD
• Laura Ann Wagner
• Roxanne Wagner, D.C.
• Vance Wagner II
• Katherine Anne Wagoner, LPN
• John C Wagonlander, DO

• General Practice Dentistry in Lakewood, CO
• Providers in Lakewood, 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 Jul 8, 2007; 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.