Active NPI
Angela Phan, DDS
- General Practice Dentistry
- Denver, CO
National Provider Identifier
1952717290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN.00202271
- Practice address
- 1400 Grove St
Denver, CO 80204-2229 - Phone
- (303) 825-2295
- Fax
- (303) 825-2244
- NPI assigned
- Jul 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN.00202271 | CO | Primary |
Addresses
Primary practice location
1400 Grove St
Denver, CO 80204-2229
Mailing address
1400 Grove St
Denver, CO 80204-2229
Phone (303) 825-2295
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150728005920 | CO | Order and Referring Only - Dentist | 4688988108 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00202271 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409270400000",
"number": "1952717290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 GROVE ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802042229",
"telephone_number": "303-825-2295",
"fax_number": "303-825-2244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 GROVE ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802042229",
"telephone_number": "303-825-2295",
"fax_number": "303-825-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "ANGELA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-08",
"last_updated": "2014-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "DEN.00202271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.