1649575127 NPI number — BELLEVIEW AND SIMMS DENTAL PROF LLC

Table of content: DR. SCOTT MICHAEL ROGERS MD (NPI 1275739575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649575127 NPI number — BELLEVIEW AND SIMMS DENTAL PROF LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELLEVIEW AND SIMMS DENTAL PROF LLC
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:
Provider Other Organization Name Type Code:
6
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:
1649575127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11625 W BELLEVIEW AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-972-8700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11625 W BELLEVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-972-8700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CONDOIANIS
Authorized Official First Name:
SEMI
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
303-972-8700

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , with the licence number:  10276 , 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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