Individual provider Active NPI

Charmaine Doan, DMD

  • General Practice Dentistry
  • Greeley, CO
National Provider Identifier
1083330237
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
205377 Issued in CO
Practice address
1006 A St
Greeley, CO 80631-2021
Phone
(970) 352-0048
NPI assigned
Oct 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 205377 CO Primary

Addresses

Primary practice location

1006 A St
Greeley, CO 80631-2021

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 350-4606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230406002881 CO Practitioner - Dentist 1456726389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Community Health CurrentSince Nov 14, 2022 Accepting new patients
Sunrise Community Health CurrentSince Nov 14, 2022 Accepting new patients
Sunrise Community Health CurrentSince Oct 23, 2022 Accepting new patients
Sunrise Community Health General Practice Past Accepting new patients
Sunrise Community Health PastSince Oct 23, 2022 Accepting new patients

Locations

2930 11th Ave
Evans, CO 80620
Phone (970) 350-4606

1006 A St
Greeley, CO 80631
Phone (970) 352-0048

302 3rd St SE
Ste 150
Loveland, CO 80537
Phone (970) 669-4855

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1083330237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-350-4606",
            "fax_number": "970-350-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 A ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806312021",
            "telephone_number": "970-352-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "CHARMAINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "205377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.