Individual provider Active NPI

Kit William Haddow, D.D.S.

  • General Practice Dentistry
  • Grand Junction, CO
National Provider Identifier
1992772859
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104969 Issued in CO
Practice address
1208 Orchard Ave
Grand Junction, CO 81501-8509
Phone
(970) 245-2990
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104969 CO Primary

Addresses

Primary practice location

1208 Orchard Ave
Grand Junction, CO 81501-8509

Mailing address

1208 Orchard Ave
Grand Junction, CO 81501-8509
Phone (970) 245-2990

Other identifiers 1

IdentifierTypeStateIssuer
02049690MedicaidCO

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
I20160422000485 CO Order and Referring Only - DentistPractitioner - Dentist 8820397060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104969COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992772859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 ORCHARD AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018509",
            "telephone_number": "970-245-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 ORCHARD AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018509",
            "telephone_number": "970-245-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOW",
        "first_name": "KIT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "104969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02049690",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.