Healthcare Provider Details

I. General information

NPI: 1750266375
Provider Name (Legal Business Name): CORNERSTONE ORTHODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9552 PARK MEADOWS DR STE 400
LONE TREE CO
80124-5338
US

IV. Provider business mailing address

1825 56TH AVE STE A
GREELEY CO
80634-3028
US

V. Phone/Fax

Practice location:
  • Phone: 303-228-0807
  • Fax:
Mailing address:
  • Phone: 970-573-5604
  • Fax: 970-573-5612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SEONG CHOI
Title or Position: ORTHODONTIST
Credential: DMD
Phone: 949-231-2625