Individual provider Active NPI

Mark J Stasi, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Littleton, CO
National Provider Identifier
1609065481
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
105444 Issued in CO
Practice address
5055 S Kipling Pkwy
Littleton, CO 80127-7932
Phone
(303) 933-8464
Fax
(303) 932-0436
NPI assigned
Oct 17, 2007
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 105444 CO Primary

Addresses

Primary practice location

5055 S Kipling Pkwy
Littleton, CO 80127-7932

Mailing address

5055 S Kipling Pkwy
Littleton, CO 80127-7932
Phone (303) 933-8464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105444COMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
CD Braces Southwest Orthodontics and Dentofacial Orthopedics CurrentSince Sep 17, 2023 Accepting new patients
Embraceable LLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

5055 S Kipling Pkwy
Littleton, CO 80127
Phone (303) 933-8464

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1609065481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 S KIPLING PKWY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801277932",
            "telephone_number": "303-933-8464",
            "fax_number": "303-932-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 S KIPLING PKWY",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801277932",
            "telephone_number": "303-933-8464",
            "fax_number": "303-932-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASI",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "105444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.