Active NPI
Kyle Diehl, PH.D., DDS
- Dentist
- Denver, CO
National Provider Identifier
1962045880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 00204086
- Practice address
- 2979 Iola St
Denver, CO 80238-3193 - Phone
- (720) 703-9116
- NPI assigned
- Oct 23, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 00204086 | CO | Primary |
| Periodontics | 1223P0300X | 204086 | CO |
Addresses
Primary practice location
2979 Iola St
Denver, CO 80238-3193
Mailing address
2222 Old Rail Way
Superior, CO 80027-8753
Phone (720) 633-7875
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00204086 | CO | MD | Dentist |
| 204086 | CO | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1962045880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 OLD RAIL WAY",
"city": "SUPERIOR",
"state": "CO",
"postal_code": "800278753",
"telephone_number": "720-633-7875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2979 IOLA ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802383193",
"telephone_number": "720-703-9116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEHL",
"first_name": "KYLE",
"credential": "PH.D., DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-23",
"last_updated": "2023-11-15",
"certification_date": "2023-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "00204086",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CO",
"license": "204086",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.