Individual provider Active NPI

Anthony C Kardelis, DDS, MS

  • Periodontics
  • Lakewood, CO
National Provider Identifier
1922062546
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8418 Issued in CO
Practice address
7373 W Jefferson Ave
#404
Lakewood, CO 80235-2038
Phone
(303) 986-2765
Fax
(303) 986-2767
NPI assigned
Apr 12, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 8418 CO
Periodontics 1223P0300X 8418 CO Primary

Addresses

Primary practice location

7373 W Jefferson Ave
#404
Lakewood, CO 80235-2038

Mailing address

7373 W Jefferson Ave
Lakewood, CO 80235-2021
Phone (303) 986-2765

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
I20160406002114 CO Order and Referring Only - DentistPractitioner - Dentist 4587962667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8418COMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1922062546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 W JEFFERSON AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802352021",
            "telephone_number": "303-986-2765",
            "fax_number": "303-986-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 W JEFFERSON AVE",
            "address_2": "#404",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802352038",
            "telephone_number": "303-986-2765",
            "fax_number": "303-986-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDELIS",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "8418",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.