NPIMap

Organization Active NPI

Ted C. Kawulok D.D.S., P.C.

  • Dentist
  • Boulder, CO
National Provider Identifier
1669850608
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5541 Issued in CO
Legal business name
TED C. KAWULOK D.D.S., P.C.
Practice address
1400 28TH St
Suite 4
Boulder, CO 80303-1096
Phone
(303) 442-8625
Fax
(303) 541-9867
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Dr. Ted C Kawulok, DDSNPI 1245223593
Title
Owner
Phone
(303) 442-8625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5541 CO Primary

Addresses

Primary practice location

1400 28TH St
Suite 4
Boulder, CO 80303-1096

Mailing address

1400 28TH St
Suite 4
Boulder, CO 80303-1096
Phone (303) 442-8625

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1669850608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 28TH ST",
            "address_2": "SUITE 4",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031096",
            "telephone_number": "303-442-8625",
            "fax_number": "303-541-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 28TH ST",
            "address_2": "SUITE 4",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031096",
            "telephone_number": "303-442-8625",
            "fax_number": "303-541-9867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED C. KAWULOK D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "KAWULOK",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-442-8625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "5541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.