Provider Demographics
NPI:1205519402
Name:DERMATOLOGY HEALTHCARE EXCELLENCE, PLLC
Entity type:Organization
Organization Name:DERMATOLOGY HEALTHCARE EXCELLENCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ALISON
Authorized Official - Last Name:BASAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-298-4664
Mailing Address - Street 1:1265 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-1808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 W JEWELL AVE STE 3
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6357
Practice Address - Country:US
Practice Address - Phone:720-778-3376
Practice Address - Fax:720-856-6117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty