Active NPI
Kimia Ahmadian, DMD
- Pediatric Dentistry
- Colorado Springs, CO
National Provider Identifier
1699369983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DEN.00205108
- Practice address
- 3630 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6661 - Phone
- (719) 304-5400
- NPI assigned
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DEN.00205108 | CO | Primary |
Addresses
Primary practice location
3630 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6661
Mailing address
3630 Austin Bluffs Pkwy
Colorado Springs, CO 80918-6661
Phone (719) 304-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240117003898 | NY | Order and Referring Only - Dentist | 7315399151 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205108 | CO | MD | Pediatric Dentist |
| 063493 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Akvc North LLC | Past | Accepting new patients |
Interoperability endpoints
- kahmadian1603338@nychhc.direct-ci.com
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.
-
- Medical Specialty Clinic/Center
- Colorado Springs, CO
- NPI 1013330208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730592000000",
"number": "1699369983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3630 AUSTIN BLUFFS PKWY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809186661",
"telephone_number": "719-304-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3630 AUSTIN BLUFFS PKWY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809186661",
"telephone_number": "719-304-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMADIAN",
"first_name": "KIMIA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-26",
"last_updated": "2024-11-03",
"certification_date": "2024-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "DEN.00205108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.