Healthcare Provider Details

I. General information

NPI: 1497271027
Provider Name (Legal Business Name): CRISTIN B HAASE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14697 DELAWARE ST UNIT 210
WESTMINSTER CO
80023-9262
US

IV. Provider business mailing address

14697 DELAWARE ST UNIT 210
WESTMINSTER CO
80023-9262
US

V. Phone/Fax

Practice location:
  • Phone: 303-650-0310
  • Fax:
Mailing address:
  • Phone: 303-650-0310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00203378
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN.00203378
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD10657
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD010150
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: