Individual provider Active NPI

Cary Wade Sanders, D.D.S., P.C.

  • Dentist
  • Fort Collins, CO
National Provider Identifier
1891788071
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6143 Issued in CO
Practice address
2000 Vermont Dr
Suite 200
Fort Collins, CO 80525-2900
Phone
(970) 482-1477
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6143 CO Primary

Addresses

Primary practice location

2000 Vermont Dr
Suite 200
Fort Collins, CO 80525-2900

Mailing address

2000 Vermont Dr
Suite 200
Fort Collins, CO 80525-2900
Phone (970) 482-1477

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
I20150130001913 CO Order and Referring Only - DentistPractitioner - Dentist 5395069967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6143COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cary W. Sanders, D.D.S., P.C. 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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1891788071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 VERMONT DR",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252900",
            "telephone_number": "970-482-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VERMONT DR",
            "address_2": "SUITE 200",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252900",
            "telephone_number": "970-482-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CARY",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "6143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.