Individual provider Active NPI

Keith Rockwood, DDS

  • General Practice Dentistry
  • Arvada, CO
National Provider Identifier
1861072142
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00205030 Issued in CO
Practice address
11005 Ralston Rd Ste 100G
Arvada, CO 80004-4551
Phone
(303) 776-7433
NPI assigned
Apr 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X DEN.00205030 CO Primary

Addresses

Primary practice location

11005 Ralston Rd Ste 100G
Arvada, CO 80004-4551

Mailing address

11005 Ralston Rd Ste 100G
Arvada, CO 80004-4551
Phone (303) 776-7433

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230125000176 CO Practitioner - Dentist 2163893462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Provider Network Inc CurrentSince Oct 13, 2022 Accepting new patients
Metro Community Provider Network, Inc. CurrentSince Oct 13, 2022 Accepting new patients
Metro Community Provider Network Inc Current Accepting new patients

Locations

11005 Ralston Rd
Ste 100G
Arvada, CO 80004
Phone (303) 431-0844

2255 S Oneida St
Denver, CO 80224

17866 Cottonwood Dr
Parker, CO 80134
Phone (303) 205-6899

Organizations & group practices 3

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1861072142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 RALSTON RD STE 100G",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044551",
            "telephone_number": "303-776-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11005 RALSTON RD STE 100G",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044551",
            "telephone_number": "303-776-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKWOOD",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00205030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

Verify at the official NPI Registry.