Individual provider Active NPI

Robert Dean Chavez, DDS MS

  • Endodontics
  • Denver, CO
National Provider Identifier
1194826784
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7116 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 436-4949
Fax
(303) 436-4610
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 7116 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

7520 Montgomery Blvd NE
BLDG C Ste B
Albuquerque, NM 87109-1521
Phone (505) 881-6902

Other practice location 1

1190 Bookcliff Ave
Suite 204
Grand Junction, CO 81501-8159
Phone (970) 242-9088

Other identifiers 1

IdentifierTypeStateIssuer
822910OtherUNITED CONCORDIA INS

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
I20190320001240 CO Practitioner - Dentist 4688914187 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7116COMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Mar 4, 2019 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 4, 2019 Accepting new patients
Colorado West Endodontics LLC Endodontics Past Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

Organizations & group practices 3

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1194826784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 MONTGOMERY BLVD NE",
            "address_2": "BLDG C STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091521",
            "telephone_number": "505-881-6902",
            "fax_number": "505-881-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-436-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 Bookcliff Ave",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815018159",
            "country_code": "US",
            "telephone_number": "970-242-9088",
            "fax_number": "970-257-0255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "ROBERT",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "7116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "822910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.