1215113402 NPI number — TOTAL ORAL PREVENTION STRATEGIES

Table of content: (NPI 1215113402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215113402 NPI number — TOTAL ORAL PREVENTION STRATEGIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL ORAL PREVENTION STRATEGIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TOPS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215113402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3216 HIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80205-4062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-394-0231
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3216 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80205-4062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-394-0231
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TAPPAN
Authorized Official First Name:
MAJOR
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
303-394-0231

Provider Taxonomy Codes

  • Taxonomy code: 1223D0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02036424 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com