Individual provider Active NPI

Kristin Nicole Lere, D.D.S

  • Dentist
  • Thornton, CO
National Provider Identifier
1689835340
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9706 Issued in CO
Practice address
2800 E 136TH Ave
Thornton, CO 80241-3417
Phone
(720) 872-2892
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9706 CO Primary
Dentist 122300000X 24656 TX

Addresses

Primary practice location

2800 E 136TH Ave
Thornton, CO 80241-3417

Mailing address

2800 E 136TH Ave
Thornton, CO 80241-3417
Phone (720) 872-2892

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
I20160601000974 CO Order and Referring Only - DentistPractitioner - Dentist 3779873930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9706COMDDentist
24656TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1689835340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E 136TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413417",
            "telephone_number": "720-872-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E 136TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413417",
            "telephone_number": "720-872-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERE",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9706",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.