DR. JUSTIN KIMBALL LIDDLE (NPI# 1154634707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154634707 |
Entity Type | Individual |
Full Name | DR. JUSTIN KIMBALL LIDDLE |
Credential | DMD, CDT |
Practice Address |
2001 S Shields St Ste B1 Fort Collins CO 80526-1829 |
Practice Telephone | 9702244358 |
Practice Fax Number | 9702244388 |
Mailing Telephone | 9702244358 |
Mailing Fax Number | 9702244388 |
Enumeration Date | 2010-07-23 |
Last Update Date | 2010-07-23 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
10142 | CO | Dental Providers |
Street Address |
2001 S SHIELDS ST STE B1 |
City | FORT COLLINS |
State | CO |
Zip Code | 80526-1829 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831736057 | Jade Elaine Tilley | Behavior Technician | 3005 Ross Drive Apt V #21, Fort Collins, CO 80526 | 2019-12-06 |
1073179131 | Jana Marie Carson | Marriage & Family Therapist | 2001 S. Shields St. Bld K, Ft. Collins, CO 80526 | 2019-05-14 |
1467922443 | Marshall Hannum | Occupational Therapist | 2312 Limousin Ct., Fort Collins, CO 80526 | 2018-12-03 |
1205326634 | Marlene A Baczek | Acupuncturist | 2001 S. Shields, Bldg B, Ste 2, Fort Collins, CO 80526 | 2018-05-10 |
1164922852 | James Joseph Reid | Social Worker | 831 Benthaven St., Ft. Collins, CO 80526 | 2018-02-19 |
1982113718 | Friends of L'arche Fort Collins | Community/Behavioral Health | 4500 Seneca St Unit 71, Fort Collins, CO 80526 | 2017-09-25 |
1578004313 | Jenessa Dyke | Chiropractor | 2531 S Shields St # 2j-h, Fort Collins, CO 80526 | 2017-03-13 |
1588102388 | Sarah Klein | Counselor | 1301 Glen Haven Dr, Fort Collins, CO 80526 | 2017-02-01 |
1972046530 | Benu Amun-ra | Non-emergency Medical Transport (VAN) | 4779 Skyline Dr, Ft. Collins, CO 80526 | 2016-11-29 |
1205280328 | Abigail Depperschmidt | Physical Therapist | 940 Worthington Circle, Fort Collins, CO 80526 | 2016-04-14 |
Find all providers in zip 80526 |
Taxonomy Code | 1223P0700X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Prosthodontics |
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568965812 | Advanced Prosthodontics | Dentist | 1006 Robertson St Ste 210, Fort Collins, CO 80524-3920 | 2018-03-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134765431 | Castle Rock Dental Prosthetics and Implants, P.C. | Dentist | 2356 Meadows Blvd Ste 170b, Castle Rock, CO 80109-8411 | 2019-11-21 |
1124531975 | Ryan Lewis, Dmd, Pllc | Dentist | 1325 Hover St Ste 103, Longmont, CO 80501-3137 | 2017-11-14 |
1932567690 | Aaron Bellis | Dentist | 8751 E Hampden Ave Ste C6, Denver, CO 80231-4930 | 2016-02-09 |
1942673397 | Colorado Springs Dental Services, PC | Dentist | 251 E Fountain Blvd Unit 100, Colorado Springs, CO 80903-4160 | 2015-11-06 |
1831531748 | Kaushal Kumar Dhawan | Dentist | 5161 E Arapahoe Rd Ste 255, Centennial, CO 80122-4810 | 2013-07-19 |
1912264318 | Paul Conrad Doran | Dentist | 9881 Foxhill Cir, Highlands Ranch, CO 80129-4330 | 2012-04-23 |
1235410200 | John Chun-fu Chen | Dentist | 6240 S Main St Ste 215, Aurora, CO 80016-5413 | 2011-09-06 |
1568694305 | Gordon N Gates Dds, Msd, PC | Dentist | 350 Broadway St Ste 201, Boulder, CO 80305-3338 | 2009-08-12 |
1164697330 | Neil Gary Dobro | Dentist | 3737 E 1st Ave, Suite A, Denver, CO 80206-7510 | 2008-04-28 |
1821268871 | Darrel Elgin Kneupper | Dentist | 1106 W Cheyenne Rd, Colorado Springs, CO 80906-2460 | 2008-03-06 |
Find all providers with the same taxonomy |
City | FORT COLLINS |
Zip Code | 80526 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.