Provider Demographics
NPI:1134252315
Name:SCHAFER, NATALIE J (DDS)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:SCHAFER
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 1:7760 W 38TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6147
Mailing Address - Country:US
Mailing Address - Phone:303-421-4010
Mailing Address - Fax:303-423-9051
Practice Address - Street 1:7760 W 38TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6147
Practice Address - Country:US
Practice Address - Phone:303-421-4010
Practice Address - Fax:303-423-9051
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO78271223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02078277Medicaid
CO291528Medicare ID - Type Unspecified
CO02078277Medicaid