Individual provider Active NPI

Kimia Ahmadian, DMD

  • Pediatric Dentistry
  • Colorado Springs, CO
National Provider Identifier
1699369983
Registry record updated Nov 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DEN.00205108 Issued in CO
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

Updated by the provider on Nov 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117003898 NY Order and Referring Only - DentistPractitioner - Dentist 7315399151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00205108COMDPediatric Dentist
063493NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Akvc North LLC PastSince Nov 10, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.