STETTLER KR BROADMOOR PLLC (NPI# 1578181103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578181103 |
Entity Type | Organization |
Organization Name | STETTLER KR BROADMOOR PLLC |
Practice Address |
4515 Broadmoor Bluffs Dr Colorado Springs CO 80906-8647 |
Practice Telephone | 7194244668 |
Practice Fax Number | 7194244667 |
Mailing Telephone | 7194244668 |
Mailing Fax Number | 7194244667 |
Enumeration Date | 2020-07-09 |
Last Update Date | 2020-07-09 |
Authorized Official Name | CORBAN STETTLER (OWNER/DDS) |
Authorized Official Telephone | 7193041305 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Kids Rock Pediatric Dentistry and Orthodontics | Doing Business As Name - Organization |
Street Address |
4515 BROADMOOR BLUFFS DR |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80906-8647 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
Find all providers in zip 80906 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881294387 | Scott Holm Dmd Pllc | Clinic/Center | 685 Citadel Dr E Ste 200b, Colorado Springs, CO 80909-5315 | 2020-10-26 |
1568075489 | Open and Affordable Dental Cs North Pllc | Clinic/Center | 6375 Lehman Dr Ste 200, Colorado Springs, CO 80918-1427 | 2020-08-29 |
1093349706 | Cantua Dds, Pllc Dba Dental Nook | Clinic/Center | 13492 Bass Pro Dr Ste 110, Colorado Springs, CO 80921-3852 | 2020-03-03 |
1932753001 | Lucas Castillo PC | Clinic/Center | 3113 W Colorado Ave, Colorado Springs, CO 80904-2040 | 2019-07-28 |
1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
1124517826 | Kazemi Dental Pllc | Clinic/Center | 5010 El Camino Dr Ste A, Colorado Springs, CO 80918-2130 | 2018-05-08 |
1013410323 | Dental Holdings, P.C., Dba Mountain Shadows Family Dentistry | Clinic/Center | 1045 Garden of The Gods Rd Ste N, Colorado Springs, CO 80907-3436 | 2018-03-13 |
1689052961 | Lovell Ortrhodontics, PC | Clinic/Center | 5426 N Academy Blvd Ste 105, Colorado Springs, CO 80918-3686 | 2015-05-07 |
1144661273 | Michael W Beasley Dds PC | Clinic/Center | 6475 Wall St Ste 202, Colorado Springs, CO 80918-8341 | 2013-07-17 |
1497787535 | Peak Vista Community Health Centers | Clinic/Center | 2828 International Circle, Suite 100, Colorado Springs, CO 80910 | 2006-07-07 |
Find all providers in COLORADO SPRINGS |
City | COLORADO SPRINGS |
Zip Code | 80906 |
Please comment or provide details below to improve the information on STETTLER KR BROADMOOR PLLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.