1083306740 NPI number — VICTORIA SUSAN GRAY DMD

Table of content: VICTORIA SUSAN GRAY DMD (NPI 1083306740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083306740 NPI number — VICTORIA SUSAN GRAY DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRAY
Provider First Name:
VICTORIA
Provider Middle Name:
SUSAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOSER
Provider Other First Name:
VICTORIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083306740
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9694 DESERT PAINT BRUSH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARKER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80134-5151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-551-5700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 E ALAMEDA AVE
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:
80209-1757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-531-7450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2023

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:  DEN.00205584 , 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)

  • Identifier: DEN.00205584 . This is a "COLORADO DORA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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