Kenneth W. Mickens II, DDS

Dentist · Boulder, CO

Individual Active NPI

NPI number 1205064151

Practice location

3400 Penrose Pl
Suite 101
Boulder, CO 80301-1809
Phone
(303) 442-8700
Fax
(303) 442-1326

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NPI record

NPI
1205064151
Entity type
Individual (Type 1)
Enumeration date
June 30, 2009
Last updated
June 30, 2009
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 7244 CO

About Dr. Mickens

Kenneth W. Mickens II, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3400 Penrose Pl, Suite 101, Boulder, CO 80301-1809. The NPI number 1205064151 was assigned on June 30, 2009 and the record was last updated on June 30, 2009.

Dr. Mickens lists a license in the registry: #7244 (CO) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kenneth W. Mickens II, DDS?

The NPI number is 1205064151.

What is the phone number of Dr. Mickens?

The phone number listed for the practice location is (303) 442-8700.

Where is Dr. Mickens located?

3400 Penrose Pl, Suite 101, Boulder, CO 80301-1809.

What is the taxonomy code for Dr. Mickens?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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