Kevin M McCormack, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00204371 Issued in CO

Practice address

18240 E 104TH Ave Unit 201
Commerce City, CO 80022-0660

Phone

(303) 928-7838

Fax

(216) 584-1363

NPI assigned

May 27, 2016

Sex

Male

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

Enrolled in OH

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 and National Provider Directory roles.

• Reunion Dental Care, LLC

  • General Practice Dentistry
  • Commerce City, CO
  • NPI 1912108960
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1891143178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 ARGONNE ST APT 12303",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802498866",
            "telephone_number": "812-322-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18240 E 104TH AVE UNIT 201",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800220660",
            "telephone_number": "303-928-7838",
            "fax_number": "216-584-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Martinez
• Rachel Cassandra Martinez, B.A.
• Emily Byrd Mason, MA, CCC-SLP
• Amberly Mast, RBT
• Brendan Scott McCasky
• Katie McCoy
• A'Mya Marie McCray
• Bruce Edward McDowell, MA, LPC, CAC II
• Kellie Kristine McGowan, B.S.
• Connie A McGuire, COTA/L

• General Practice Dentistry in Commerce City, CO
• Providers in Commerce City, 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 Jul 7, 2020; 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.