Active NPI
Richard Keaton Jolley, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Grand Junction, CO
National Provider Identifier
1932774395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DEN.00204147
- Practice address
- 601 28 1/4 Rd Unit E
Grand Junction, CO 81506-6022 - Phone
- (570) 523-6333
- NPI assigned
- May 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DEN.00204147 | CO | Primary |
Addresses
Primary practice location
601 28 1/4 Rd Unit E
Grand Junction, CO 81506-6022
Mailing address
600 Manor Glen Dr
Suwanee, GA 30024-3517
Phone (801) 361-6446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00204147 | CO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1932774395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 MANOR GLEN DR",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300243517",
"telephone_number": "801-361-6446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 28 1/4 RD UNIT E",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815066022",
"telephone_number": "570-523-6333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLEY",
"first_name": "RICHARD",
"middle_name": "KEATON",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-26",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CO",
"license": "DEN.00204147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.