Mark Joseph Cassidy, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

105766 Issued in CO

Practice address

6979 S Holly Cir
#280
Centennial, CO 80112-1577

Phone

(303) 779-1977

Fax

(303) 779-2530

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619004868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "#280",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-779-1977",
            "fax_number": "303-779-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR",
            "address_2": "#280",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121577",
            "telephone_number": "303-779-1977",
            "fax_number": "303-779-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "105766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Carton, LPC
• Stephanie Marie Caruso, MSW, CSWC
• Mackenzie Caschette, BCBA
• William Louis Case, DMD
• Zachary Cashin, D.C.
• Castle Pines Medical, Inc.
• Michelle Musso Castro
• Marquita H Catallo-Madruga, DPT, CFDN
• Dianna Cate, OTR
• Catholic Health Iniatives Colorado

• Orthodontics and Dentofacial Orthopedics Dentistry in Centennial, CO
• Providers in Centennial, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.