Kids Tooth Doc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

KIDS TOOTH DOC

Practice address

5168 S Broadway
Englewood, CO 80113-6706

Phone

(303) 974-5868

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Brian Fox

Title

Manager

Phone

(303) 947-7705

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Rocky Mountain Kids Dentistry Doing business as
• Childrens Dental Specialist of Colorado Former legal business name

Tax ID family

Kids Tooth Doc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kids Tooth Doc

  • Pediatric Dentistry
  • Highlands Ranch, CO
  • NPI 1124560669
  NPD tax ID
• Kids Tooth Doc

  • Pediatric Dentistry
  • Castle Pines, CO
  • NPI 1760924203
  NPD tax ID

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1689012122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5168 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801136706",
            "telephone_number": "303-974-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 S BROADWAY",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801136706",
            "telephone_number": "303-974-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS TOOTH DOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "303-947-7705"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92133312",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Mountain Kids Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Childrens Dental Specialist of Colorado",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lisa S Kettering, MD
• Kevin J. Reilly, Psy.D.,P.C.
• Brandon Key, M.D.
• Jennifer Marie Key
• Kids Mile High Pediatric Dentistry and Orthodontics, PLLC
• Brook Kilian, FNP-C
• Samuel J. Killian
• Kevin Kilpatrick
• Ryan Lewis Kim, MD
• Kimberly C Stone MD PC

• Pediatric Dentistry in Englewood, CO
• Providers in Englewood, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.