MEDICARE: KATHLEEN FREUND 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.00205567	CO

General Provider Information

NPI Number	:	1982394748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FREUND DDS

Provider Business Mailing Address
First Line	:	3722 TRAVER RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-5151
Country	:	US
Telephone Number	:	216-375-7001
Fax Number	:

Provider Business Practice Location Address
First Line	:	994 W DILLON RD STE 400
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-8404
Country	:	US
Telephone Number	:	303-673-0500
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	05/15/2023

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