Individual provider Active NPI

Daniel Keith Duvall, DDS

  • Dentist
  • Lakewood, CO
National Provider Identifier
1669654265
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05145 Issued in CO
Practice address
3333 S Wadsworth Blvd
Ste 316
Lakewood, CO 80227
Phone
(303) 986-0043
Fax
(303) 986-0043
NPI assigned
Dec 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 05145 CO Primary

Addresses

Primary practice location

3333 S Wadsworth Blvd
Ste 316
Lakewood, CO 80227

Mailing address

3333 S Wadsworth Blvd
Ste 316
Lakewood, CO 80227
Phone (303) 986-0043

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
I20231205001265 CO Order and Referring Only - DentistPractitioner - Dentist 4183913890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05145COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1669654265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S WADSWORTH BLVD",
            "address_2": "STE 316",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80227",
            "telephone_number": "303-986-0043",
            "fax_number": "303-986-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S WADSWORTH BLVD",
            "address_2": "STE 316",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80227",
            "telephone_number": "303-986-0043",
            "fax_number": "303-986-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "DANIEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "05145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.