Healthcare Provider Details

I. General information

NPI: 1447968755
Provider Name (Legal Business Name): MISCH FACIAL PLASTIC SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E HAMPDEN AVE STE 300
ENGLEWOOD CO
80113-2795
US

IV. Provider business mailing address

500 E HAMPDEN AVE STE 300
ENGLEWOOD CO
80113-2886
US

V. Phone/Fax

Practice location:
  • Phone: 330-714-6937
  • Fax:
Mailing address:
  • Phone: 303-567-7703
  • Fax: 303-567-7703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: EMILY MISCH
Title or Position: OWNER
Credential: MD
Phone: 330-714-6937