Individual provider Active NPI

Jefferey A Stang, DDS

  • Dentist
  • Westminster, CO
National Provider Identifier
1760554307
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6399 Issued in CO
Practice address
9100 W 100TH Ave
#5B
Westminster, CO 80021-6811
Phone
(303) 420-9720
Fax
(303) 420-0086
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6399 CO Primary

Addresses

Primary practice location

9100 W 100TH Ave
#5B
Westminster, CO 80021-6811

Mailing address

9100 W 100TH Ave
#5B
Westminster, CO 80021-6811
Phone (303) 420-9720

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
I20170407001233 CO Order and Referring Only - DentistPractitioner - Dentist 8022394956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6399COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Dental Professionals, LLC Dentist Past Accepting new patients

Organizations & group practices 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760554307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 100TH AVE",
            "address_2": "#5B",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216811",
            "telephone_number": "303-420-9720",
            "fax_number": "303-420-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 100TH AVE",
            "address_2": "#5B",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216811",
            "telephone_number": "303-420-9720",
            "fax_number": "303-420-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANG",
        "first_name": "JEFFEREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "6399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.