Provider Demographics
NPI:1780938274
Name:CAREPOINT ANESTHESIA GROUP LLC
Entity type:Organization
Organization Name:CAREPOINT ANESTHESIA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-606-4220
Mailing Address - Street 1:8301 E PRENTICE AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2990
Mailing Address - Country:US
Mailing Address - Phone:720-606-4220
Mailing Address - Fax:720-606-4221
Practice Address - Street 1:8301 E PRENTICE AVE STE 215
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2990
Practice Address - Country:US
Practice Address - Phone:720-606-4220
Practice Address - Fax:720-606-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223D0004X
CO002018561223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84638877Medicaid