Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1205064151 Individual Practitioner Male Practitioner

Dr. Kenneth W Mickens , DDS

Dentist • Boulder, CO

Professional Overview & Biography Verified Profile Summary

Dr. Kenneth Mickens, DDS is a registered healthcare professional specializing in Dentist in Boulder, CO. Practice services are available at 3400 PENROSE PL under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3400 Penrose Pl
Suite 101

Boulder, CO 803011809

Telephone 3034428700
Fax 3034421326
Associated Practice Facility / Clinic
🏢 Markowitz & Wong Orthodontics Facility NPI 1477766178

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Boulder, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.2 Yrs
Regional Practice Density
43 Specialists

Practicing in Boulder, CO (2100 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CO 7244

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Dr. Michael Jones , DDS

Dentist - Pediatric Dentistry

NPI 1043286107

Doctor of Dental Surgery

Dr. Robert Holden , DDS

Dentist - General Practice

NPI 1194941625

Doctor of Dental Surgery

Dr. Kenneth Poulsen , DDS

Dentist - General Practice

NPI 1700950391

Doctor of Dental Surgery

Dr. Edward Barrett , DDS

Dentist - General Practice

NPI 1750413316

Doctor of Dental Surgery

Dr. Andrew Johann , DDS, MS

Dentist - Prosthodontics

NPI 1780800581

Doctor of Dental Surgery, Master of Science

Dr. Andrew Fiscus , DDS

Dentist - General Practice

NPI 1902805138

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 30, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location June 30, 2009

Registered at 3400 PENROSE PL, SUITE 101, BOULDER, CO 803011809 (Tel: 3034428700)

📍
Updated Business Mailing Address June 30, 2009

Registered at 3400 PENROSE PL, SUITE 101, BOULDER, CO 803011809 (Tel: 3034428700)

👤
Provider Name / Credentials Updated June 30, 2009

Recorded as KENNETH MICKENS, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 30, 2009

Dentist (License #7244 in CO)

🟢
Initial NPI Registration & Enumeration June 30, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205064151
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2009
Last Update: June 30, 2009
Sole Proprietor: Yes

Mailing Address

3400 Penrose Pl, Suite 101

Boulder, CO 803011809

Phone: 3034428700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.