1235130006 NPI number — DR. DANIEL GORDON HILL DDS

Table of content: DR. DANIEL GORDON HILL DDS (NPI 1235130006)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235130006 NPI number — DR. DANIEL GORDON HILL DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
DANIEL
Provider Middle Name:
GORDON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILL
Provider Other First Name:
DANIEL
Provider Other Middle Name:
G
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1235130006
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1120 W. SOUTH BOULDER ROAD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-625-1968
Provider Business Mailing Address Fax Number:
720-638-2931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1120 W. SOUTH BOULDER ROAD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-625-1968
Provider Business Practice Location Address Fax Number:
720-638-2931
Provider Enumeration Date:
08/03/2005

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:  7990 , 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: 739667 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".




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