Individual provider Active NPI

Marcie Ahman Flack, D.D.S.

  • Pediatric Dentistry
  • Littleton, CO
National Provider Identifier
1609021740
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9901 Issued in CO
Practice address
8906 W Bowles Ave Ste 200
Littleton, CO 80123-3400
Phone
(303) 973-4424
NPI assigned
Nov 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 9901 CO Primary
Pediatric Dentistry 1223P0221X DD379 NM

Addresses

Primary practice location

8906 W Bowles Ave Ste 200
Littleton, CO 80123-3400

Mailing address

8778 Partridge St
Littleton, CO 80126-5261
Phone (614) 595-8756

Other practice location 1

10146 W San Juan Way Unit 220
Littleton, CO 80127-6326
Phone (303) 979-9500

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

LicenseStateTypeSpecialty
9901COMDPediatric Dentist
DD379NMMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Kids Dental Pediatric Dentistry CurrentSince May 9, 2021 Accepting new patients
Courtney R. College, DDS, Ms, PC Pediatric Dentistry Past Accepting new patients

Locations

8906 W Bowles Ave
Ste 200
Littleton, CO 80123
Phone (303) 973-4424

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1609021740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8778 PARTRIDGE ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801265261",
            "telephone_number": "614-595-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 W BOWLES AVE STE 200",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801233400",
            "telephone_number": "303-973-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10146 W San Juan Way Unit 220",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801276326",
            "country_code": "US",
            "telephone_number": "303-979-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLACK",
        "first_name": "MARCIE",
        "middle_name": "AHMAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "9901",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.