Healthcare Provider Details
I. General information
NPI: 1760863583
Provider Name (Legal Business Name): KARA CARLETON D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/17/2015
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15435 GLENEAGLE DR STE 200
COLORADO SPRINGS CO
80921
US
IV. Provider business mailing address
15435 GLENEAGLE DR STE 200
COLORADO SPRINGS CO
80921-2542
US
V. Phone/Fax
- Phone: 719-481-6788
- Fax:
- Phone: 719-481-6788
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DEN.00203022 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DN014984 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: