Individual provider Active NPI

Kevin Schwandt, D.D.S.

  • Dentist
  • Aurora, CO
National Provider Identifier
1841641917
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00203231 Issued in CO
Practice address
3095 S Parker Rd Ste 150
Aurora, CO 80014-2917
Phone
(303) 755-8388
NPI assigned
Jun 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001350-15 WI
Dentist 122300000X DEN.00203231 CO Primary

Addresses

Primary practice location

3095 S Parker Rd Ste 150
Aurora, CO 80014-2917

Mailing address

11958 Ridge Pkwy Apt 106
Broomfield, CO 80021-5070
Phone (701) 412-8502

Other practice location 1

121 E Terhune St
Viroqua, WI 54665-1654
Phone (608) 637-2653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20161202000020 WI Order and Referring Only - DentistPractitioner - Dentist 5193005486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00203231COMDDentist
1001350-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reclaim Dentistry, PLLC CurrentSince Apr 24, 2022 Accepting new patients

Locations

7900 W 44th Ave
Ste 101
Wheat Ridge, CO 80033
Phone (303) 422-7978

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1841641917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11958 RIDGE PKWY APT 106",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800215070",
            "telephone_number": "701-412-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 S PARKER RD STE 150",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142917",
            "telephone_number": "303-755-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 E Terhune St",
            "address_purpose": "LOCATION",
            "city": "Viroqua",
            "state": "WI",
            "postal_code": "546651654",
            "country_code": "US",
            "telephone_number": "608-637-2653",
            "fax_number": "608-637-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWANDT",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001350-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.