Active NPI
Lisa Carlson-Marks, D.D.S.
- Pediatric Dentistry
- Glendale, CO
National Provider Identifier
1952301582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 7396
- Practice address
- 4500 Cherry Creek South Dr
# 840
Glendale, CO 80246-1518 - Phone
- (303) 377-1148
- Fax
- (303) 388-2142
- NPI assigned
- Jul 26, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 7396 | CO | Primary |
Addresses
Primary practice location
4500 Cherry Creek South Dr
# 840
Glendale, CO 80246-1518
Mailing address
2556 S Clayton St
Denver, CO 80210-6115
Phone (303) 377-1148
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71905774 | Medicaid | CO | |
| 55931375 | Medicaid | CO |
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 |
|---|---|---|---|
| 7396 | CO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Co Specialty Dental Services PLLC | Pediatric Dentistry | Past | Accepting new patients |
| Co Specialty Dental Services PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatric Dentistry
- Glendale, CO
- NPI 1881338234
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Castle Rock, CO
- NPI 1912671520
Pediatric Dentistry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337126400000",
"number": "1952301582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2556 S CLAYTON ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802106115",
"telephone_number": "303-377-1148",
"fax_number": "303-388-2142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 CHERRY CREEK SOUTH DR",
"address_2": "# 840",
"city": "GLENDALE",
"state": "CO",
"postal_code": "802461518",
"telephone_number": "303-377-1148",
"fax_number": "303-388-2142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON-MARKS",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-26",
"last_updated": "2012-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "7396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71905774",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55931375",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.