Provider Demographics
NPI:1447571245
Name:MCCANN, KATIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:MCCANN
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 1:3160 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3515
Mailing Address - Country:US
Mailing Address - Phone:720-775-8180
Mailing Address - Fax:
Practice Address - Street 1:10650 GARDEN DR UNIT 106
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-7019
Practice Address - Country:US
Practice Address - Phone:303-366-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10210122300000X
GADN014713122300000X
NMDD3844122300000X
UT8501554-8903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist