MEDICARE: DR. KATHRYN G NAGEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DEN.00204762	CO

General Provider Information

NPI Number	:	1598987406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN G NAGEL DDS

Provider Business Mailing Address
First Line	:	2417 N PERRY PARK RD
Second Line	:
City	:	SEDALIA
State	:	CO
Zip	:	80135-8533
Country	:	US
Telephone Number	:	303-815-5140
Fax Number	:

Provider Business Practice Location Address
First Line	:	7325 S PIERCE ST STE 201
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-4553
Country	:	US
Telephone Number	:	303-805-4655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	06/18/2021

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