Provider Demographics
NPI:1407850084
Name:BELONGEA, CHAD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:MICHAEL
Last Name:BELONGEA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10843 HEATHERTON ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-6622
Mailing Address - Country:US
Mailing Address - Phone:419-779-0985
Mailing Address - Fax:
Practice Address - Street 1:7735 W LONG DR UNIT 9
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-1262
Practice Address - Country:US
Practice Address - Phone:303-933-8880
Practice Address - Fax:303-442-4396
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2015-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300213851223G0001X
CODEN.00201939122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODEN.00201939OtherDENTAL LICENSE
OH30021385OtherDENTAL LICENSE