Provider Demographics
NPI:1487213435
Name:CREPPS, SARAH CORINE (DDS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CORINE
Last Name:CREPPS
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 1:8120 S HOLLY ST STE 214
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-4007
Mailing Address - Country:US
Mailing Address - Phone:303-796-7676
Mailing Address - Fax:
Practice Address - Street 1:8120 S HOLLY ST STE 214
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4007
Practice Address - Country:US
Practice Address - Phone:303-796-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190184421223G0001X
CO002046601223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty