Stacey Y Cha, D.M.D.
Individual provider Active NPI Dentist · Firestone, CO
NPI 1598137366 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1598137366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 202677 (CO)
- Practice address
- 6130 Firestone Blvd Unit 503
Firestone, CO 80504-6935 - Phone
- (720) 774-6087
- NPI assigned
- Oct 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202677 | CO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 202677 | CO | Yes |
Addresses
Primary practice location
6130 Firestone Blvd Unit 503
Firestone, CO 80504-6935
Mailing address
999 S Logan St Apt 230
Denver, CO 80209-5814
Phone (201) 394-4141
Other providers in Firestone, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.