Colleen Kimball, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

00204061 Issued in CO

Practice address

3140 Village Vista Dr Unit 108
Erie, CO 80516-2529

Phone

(303) 604-0034

NPI assigned

Jun 25, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Colleen Kimball Bullard, DDS, PLLC

  • Dental Clinic/Center
  • Longmont, CO
  • NPI 1467220301
  NPD
• Colorado Dental Professionals, LLC

  dba Aspen View Dental

  • General Practice Dentistry
  • Littleton, CO
  • NPI 1154803252
  NPD (past)
• Vista Ridge Dental Care, LLC

  dba Vista Ridge Dental Care

  • General Practice Dentistry
  • Erie, CO
  • NPI 1053587584
  NPD (past)

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1811558430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 VILLAGE VISTA DR UNIT 108",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162529",
            "telephone_number": "303-604-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 VILLAGE VISTA DR UNIT 108",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162529",
            "telephone_number": "303-604-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00204061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Kelway, DIHOM NTP BHCN
• Douglas W Kennedy, OD
• Karen Kepart, R.N.
• Kerr Chiropractic Clinic PLC
• Amanda Kilen, PHARMD
• Jamie King, LCSW
• Lauren Kline, MS CCC-SLP
• Angela M. Kloepfer-Shapiro, MD
• Ryan Fredric Koelling, DPT
• Alexa Evanka Kowaluk, DC

• General Practice Dentistry in Erie, CO
• Providers in Erie, 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 Oct 15, 2020; 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.