1366591125 NPI number — TERRENCE SHEA BATLINER DDS, MBA

Table of content: RACHELE DENISE WALDER (NPI 1780483610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366591125 NPI number — TERRENCE SHEA BATLINER DDS, MBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATLINER
Provider First Name:
TERRENCE
Provider Middle Name:
SHEA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS, MBA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1366591125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MAIL STOP F831, P.O. BOX 6508
Provider Second Line Business Mailing Address:
UNIVERSITY OF COLORADO SCHOOL OF DENTISTRY
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-724-1037
Provider Business Mailing Address Fax Number:
303-724-7109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
390 UNIVERSITY BLVD
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:
80206-4125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-333-6016
Provider Business Practice Location Address Fax Number:
303-333-0779
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  5542 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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