Provider Demographics
NPI:1093433906
Name:DINGUS, STACI (DDS)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:DINGUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 E BERRY AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2103
Mailing Address - Country:US
Mailing Address - Phone:303-741-2717
Mailing Address - Fax:
Practice Address - Street 1:7447 E BERRY AVE STE 240
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2103
Practice Address - Country:US
Practice Address - Phone:303-741-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist