Individual provider Active NPI

Kerri Lyn Lawlor, DDS

  • Endodontics
  • Lone Tree, CO
National Provider Identifier
1679551881
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
9815 Issued in CO
Practice address
10107 Ridgegate Pkwy Ste G020
Lone Tree, CO 80124-5637
Phone
(720) 507-2241
Fax
(720) 507-2221
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60009 KS
Endodontics 1223E0200X 9815 CO Primary

Addresses

Primary practice location

10107 Ridgegate Pkwy Ste G020
Lone Tree, CO 80124-5637

Mailing address

10107 Ridgegate Pkwy Ste G020
Lone Tree, CO 80124-5637
Phone (720) 507-2241

Other identifiers 1

IdentifierTypeStateIssuer
100369330-AMedicaidKS

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
I20150929002502 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103134879

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9815COMDEndodontist
60009KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Endodontics, PLLC Endodontics CurrentSince Jul 5, 2020 Accepting new patients

Locations

10107 Ridgegate Pkwy
#G20
Lone Tree, CO 80124
Phone (720) 507-2221

Organizations & group practices 1

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1679551881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10107 RIDGEGATE PKWY STE G020",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245637",
            "telephone_number": "720-507-2241",
            "fax_number": "720-507-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10107 RIDGEGATE PKWY STE G020",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245637",
            "telephone_number": "720-507-2241",
            "fax_number": "720-507-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLOR",
        "first_name": "KERRI",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60009",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "9815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100369330-A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.