Yoel Ephrem Kidane

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00205691 Issued in CO

Practice address

7650 W Virginia Ave Unit a
Lakewood, CO 80226-3131

Phone

(303) 222-0296

NPI assigned

Aug 31, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakewood Modern Dentistry, LLP

  dba Lakewood Modern Dentistry

  • Dentist
  • Lakewood, CO
  • NPI 1861943771
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1801672316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 W VIRGINIA AVE UNIT A",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802263131",
            "telephone_number": "303-222-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 W VIRGINIA AVE UNIT A",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802263131",
            "telephone_number": "303-222-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDANE",
        "first_name": "YOEL",
        "middle_name": "EPHREM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00205691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Keyser
• Anthony P. Khalifah, M.D.
• Hari Khalsa, M.D.
• Taimur Khan, M.D.
• Kheyre and Moalim Corporation
• Gerald Steele Kidd III, PA-C
• Sara M Kidd, LPC
• Kidney Center of Bear Creek LLC
• Kidney Center of Lakewood LLC (Kidney Center of Lakewood)
• Kids Overcoming, LLC

• General Practice Dentistry in Lakewood, CO
• Providers in Lakewood, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.

Verify at the official NPI Registry.