Provider Demographics
NPI:1538057146
Name:STASI ORTHODONTICS PLLC
Entity type:Organization
Organization Name:STASI ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:STASI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-594-6584
Mailing Address - Street 1:8223 S QUEBEC ST STE O
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3173
Mailing Address - Country:US
Mailing Address - Phone:303-220-0550
Mailing Address - Fax:
Practice Address - Street 1:354 BLUE RIVER PARKWAY
Practice Address - Street 2:UNIT A
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498
Practice Address - Country:US
Practice Address - Phone:720-826-7871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STASI ORTHODONTICS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty