SHADOW ROCK DENTIST LLC (NPI# 1346509429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346509429 |
| Entity Type | Organization |
| Organization Name | SHADOW ROCK DENTIST LLC |
| Practice Address |
734 Wilcox St #200 Castle Rock CO 80104-1709 |
| Practice Telephone | 3032578237 |
| Practice Fax Number | 3038143761 |
| Mailing Telephone | 3032578237 |
| Mailing Fax Number | 3038143761 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |
| Authorized Official Name | DR. VIKASH KANCHANLAL (PRESIDENT) |
| Authorized Official Telephone | 3032578237 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
CO | Dental Providers |
| Street Address |
734 WILCOX ST #200 |
| City | CASTLE ROCK |
| State | CO |
| Zip Code | 80104-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437616463 | Jessica Vaeth | Counselor | 734 Wilcox St, Castle Rock, CO 80104-1709 | 2019-02-26 |
| 1780128504 | Geoffrey Rink | Counselor | 734 Wilcox St, Suite 202, Castle Rock, CO 80104-1709 | 2016-12-13 |
| 1467801159 | Aaron Kadavy | Counselor | 734 Wilcox St, Castle Rock, CO 80104-1709 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932737152 | F2dis, Limited Liability Company | Skilled Nursing Facility | 1055 S. Perry Street, Castle Rock, CO 80104 | 2020-04-01 |
| 1518497262 | Courtney Renee Mcmurtry | Dental Hygienist | 610 E. Fifth St., Suite 300, Castle Rock, CO 80104 | 2017-06-15 |
| 1235598350 | Village Physical Therapy, PC | Specialist | 1184 South Perry Street, Suite 230, Castle Rock, CO 80104 | 2016-02-17 |
| 1730513318 | Erin Evers | Physical Therapist | 4348 Woodlands Boulevard, Suite 100, Castle Rock, Co, CO 80104 | 2013-08-30 |
| 1730424185 | Ange' Anesthesia | Nurse Anesthetist, Certified Registered | 157 Crosshaven Pl, Castle Rock, CO 80104 | 2012-12-11 |
| 1902155013 | Rachel Everett | Marriage & Family Therapist | 831 S Perry Street, Suite 100, Castle Rock, CO 80104 | 2012-09-05 |
| 1922366889 | Health Connections of Castle Rock, Inc. | Massage Therapist | 323 Metzler Dr #105, Castle Rock, CO 80104 | 2012-04-30 |
| 1326313255 | Kate Ivey | Counselor | 4889 Thorndike Ave, Castle Rock, CO 80104 | 2012-03-10 |
| 1902106578 | Gordon Talmadge Blair IIi | Physical Therapist | 814 S. Perry St., Suit 101, Castle Rock, CO 80104 | 2010-10-28 |
| 1285943936 | Denise L Lucia | Psychologist | 509 Wilcox Street, Suite 101, Castle Rock, CO 80104 | 2010-09-29 |
| Find all providers in zip 80104 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588279350 | Parker Alan Drake | Dentist | 36 E Allen St Ste 100, Castle Rock, CO 80108-7823 | 2020-09-09 |
| 1053884270 | Lthaws LLC | Dentist | 858 W Happy Canyon Rd Ste 135, Castle Rock, CO 80108-3916 | 2019-01-10 |
| 1063942456 | Matthew Joseph Lake | Dentist | 390 S Wilcox St Ste A, Castle Rock, CO 80104-1951 | 2017-06-18 |
| 1124409552 | Modern Dental Profesionals Co PC | Dentist | 188 Founders Pkwy # A, Castle Rock, CO 80104-7528 | 2015-06-11 |
| 1740625730 | Kylee Brightside | Dentist | 1161 S Perry St Ste 100, Castle Rock, CO 80104-1981 | 2013-05-03 |
| 1457625691 | Castle Rock Modern Dentistry, LLP | Dentist | 36 East Allen Street, Ste. 100, Castle Rock, CO 80108 | 2012-03-06 |
| 1407166770 | Scott Ryan | Dentist | 850 Happy Canyon Road, Castle Rock, CO 80108 | 2010-10-20 |
| 1437333762 | Jeffrey Martin Rayl | Dentist | 858 W Happy Canyon Rd, Ste. 135, Castle Rock, CO 80108-3912 | 2007-12-21 |
| 1174712152 | Aaron Pierce Goodman | Dentist | 3993 Limelight Ave., E, Castle Rock, CO 80109 | 2007-10-16 |
| 1376761320 | D Michael Desimone I | Dentist | 718 Maleta Lane, Suite 102, Castle Rock, CO 80108 | 2007-04-23 |
| Find all providers in CASTLE ROCK | ||||
| City | CASTLE ROCK |
| Zip Code | 80104 |
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| 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.