Healthcare Provider Details

I. General information

NPI: 1255882650
Provider Name (Legal Business Name): CARLY SCHRADE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 IRIS DR
STERLING CO
80751-4740
US

IV. Provider business mailing address

13272 COUNTY ROAD 37
STERLING CO
80751-9004
US

V. Phone/Fax

Practice location:
  • Phone: 970-522-4050
  • Fax: 970-522-4067
Mailing address:
  • Phone: 970-580-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number00203216
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number00203216
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: