Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kory Wallin, DMD

Individual provider Dentist · NPI 1477818052

Kory Wallin, DMD is a Dentist in Longmont, Colorado. Practices as a sole proprietor. Licensed in Colorado.

Licensed in
CO
In the registry since
2012
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1100 Ken Pratt Blvd Ste E
Longmont, CO 80501-6380
Phone: (720) 458-6684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 10742 (CO)

Record details

NPI number1477818052
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedJuly 10, 2012
Last updated in NPPESFebruary 17, 2023
Certification dateFebruary 17, 2023
Mailing address1100 Ken Pratt Blvd Unit E, Longmont, CO 80501

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