DR. KEITH ALLEN VAN TASSELL (NPI# 1366585408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366585408 |
| Entity Type | Individual |
| Full Name | DR. KEITH ALLEN VAN TASSELL |
| Credential | D.D.S. |
| Practice Address |
2001 S Shields St Bldg A Suite 2 Fort Collins CO 80526-1827 |
| Practice Telephone | 9704844104 |
| Practice Fax Number | 9704845245 |
| Mailing Telephone | 9704844104 |
| Mailing Fax Number | 9704845245 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
9197 | CO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962648568 | Keith M Van Tassell | Occupational Therapist | 243 Demorest Ave, Staten Island, NY 10314-3160 | 2009-01-02 |
| Street Address |
2001 S SHIELDS ST BLDG A SUITE 2 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80526-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043791627 | Samantha Lindsay | Physical Therapist | 2001 S Shields St Bldg A, Fort Collins, CO 80526-1827 | 2018-08-22 |
| 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 | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871850131 | Moira Gini Groh | Dentist | 2121 Midpoint Dr Ste 102, Fort Collins, CO 80525 | 2012-04-11 |
| 1568765105 | Mountain Kids Pediatric Dentistry | Dentist | 2016 Orchard Pl, Fort Collins, CO 80521-3213 | 2010-12-20 |
| 1760708127 | Joseph L Jackson | Dentist | 1241 Riverside Ave, Fort Collins, CO 80524-3204 | 2010-04-10 |
| 1144498999 | Pediatric Dentistry of The Rockies Pllc | Dentist | 4609 S Timberline Rd, Suite 103b, Fort Collins, CO 80528-3170 | 2008-02-14 |
| 1215083142 | Gregory Dean Evans | Dentist | 3221 Eastbrook Dr, A-101, Fort Collins, CO 80525 | 2007-01-25 |
| 1992894562 | Jennifer K Hargleroad | Dentist | 2105 Bighorn Rd Ste 202, Fort Collins, CO 80525-3575 | 2006-10-12 |
| 1033207329 | Marykate Rusnak | Dentist | 3600 Mitchell Drive, Suite 40, Mountain Kids Pediatric Dentistry, Fort Collins, CO 80525 | 2006-10-11 |
| 1730635178 | Ncdi Drake, Professional LLP | Dentist | 383 W Drake Rd, Suite 103, Fort Collins, CO 80526-2884 | 2016-08-26 |
| 1275089617 | Ncdi Oak, Profession LLP | Dentist | 1220 Oak Park Dr, Fort Collins, CO 80525-7348 | 2016-08-26 |
| 1801277926 | Jennifer K Hargleroad Dds Ms Professional LLC | Dentist | 2105 Bighorn Rd, Suite 202, Fort Collins, CO 80525-3555 | 2015-06-15 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80526 |
Please comment or provide details below to improve the information on DR. KEITH ALLEN VAN TASSELL.
| 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.