Aspen Oral and Facial Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

55871 Issued in CO

Legal business name

ASPEN ORAL AND FACIAL SURGERY, PLLC

Practice address

671 Mitchell Way
Suite 100
Erie, CO 80516

Phone

(720) 990-0381

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Eugene C Kang, MD, DMD

Title

President

Phone

(720) 990-0381

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1295271450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 MITCHELL WAY SUITE 100",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "80516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 MITCHELL WAY",
            "address_2": "SUITE 100",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "80516",
            "telephone_number": "720-990-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN ORAL AND FACIAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-990-0381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "55871",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "202361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Elizabeth Angelini
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• Julie A Atabe, MSE, LPC
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• Leah Morgan Baer, BA
• Francisco Javier Barajas de la Rocha, M.D.
• Anna Battista

• Oral and Maxillofacial Surgery Clinic/Center in Erie, CO
• Providers in Erie, CO by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.