Individual provider Active NPI

Alix Greenman

  • Oral and Maxillofacial Surgery (Dentist)
  • Littleton, CO
National Provider Identifier
1790292431
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN.00008258 Issued in CO
Practice address
6179 S Balsam Way Ste 100
Littleton, CO 80123-3092
Phone
(303) 933-8282
Fax
(303) 948-5610
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DEN.00008258 CO Primary

Addresses

Primary practice location

6179 S Balsam Way Ste 100
Littleton, CO 80123-3092

Mailing address

398 Crescent Lake Rd
Golden, CO 80403-9401
Phone (303) 917-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00008258COMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1790292431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 CRESCENT LAKE RD",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804039401",
            "telephone_number": "303-917-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6179 S BALSAM WAY STE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801233092",
            "telephone_number": "303-933-8282",
            "fax_number": "303-948-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENMAN",
        "first_name": "ALIX",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00008258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.