EXPERIENCE DENTAL PLLC


Address: 1933 28th St Ste 204, Boulder, CO 80301-1100
Phone: 7407060765

EXPERIENCE DENTAL PLLC (NPI# 1013568963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013568963
Entity Type Organization
Organization Name EXPERIENCE DENTAL PLLC
Practice Address 1933 28th St Ste 204
Boulder
CO 80301-1100
Mailing Address 4827 Thunderbird Dr Apt 44
Boulder
CO 80303-3853
Practice Telephone 7407060765
Mailing Telephone 7407060765
Enumeration Date 2019-09-23
Last Update Date 2019-09-23
Authorized Official Name JEREMY RICHARD ALTDORFER (CEO)
Authorized Official Telephone 7407060765
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1306456421 Experience Dental Pllc Clinic/Center 7001 S Custer Rd, Ste 200, Mckinney, TX 75070-7507 2020-08-04

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Experience Dental PLLC 1933 28th Street, Suite 204, Boulder, CO 80301

Office Location

Street Address 1933 28TH ST STE 204
City BOULDER
State CO
Zip Code 80301-1100

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780235713 Jeremy Richard Altdorfer Dentist 1933 28th St Ste 204, Boulder, CO 80301-1100 2019-09-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265031454 Jonathan William Garson Social Worker 1790 30th St., Boulder, CO 80301 2020-10-20
1164048161 Crossroads Medical Center Family Medicine 2760 29th St., Suite 28, Boulder, CO 80301 2020-06-25
1316585045 Karissa Marlene Smith Registered Nurse 4770 Pearl Street, Suite A, Boulder, CO 80301 2019-12-12
1184273864 National Doula Network Doula 5918 Gunbarrel Ave Apt E, Boulder, CO 80301 2019-09-05
1861047086 Samuel Shay Chiropractor 1750 30th St, Ste 1, #226, Boulder, CO 80301 2019-08-05
1124504808 Be Free Live Now LLC Social Worker 2945 Center Creen Court, Suite G211, Boulder, CO 80301 2018-07-16
1720596703 Janis Dochterman Counselor 5378 Sterling Drive, Studio #3, Boulder, CO 80301 2018-01-12
1033628631 Whitney Shea Physical Therapy Assistant 3020 Carbon Place, #330, Physical Therapy of Boulder, Boulder, CO 80301 2017-09-26
1538688908 Kyle N. Daniel Dds PC Dentist 2830 Valmont Rd, Boulder, CO 80301 2017-09-16
1497205231 Jenna Orosco Counselor 2945 Center Green Ct. Suite H, Suite H, Boulder, CO 80301 2016-10-05
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124641675 Toth Family Dental Clinic/Center 6700 Lookout Rd Ste 2, Boulder, CO 80301-3313 2020-05-19
1760969059 Boulder Endodontics Pllc Clinic/Center 3100 Arapahoe Ave Ste 300, Boulder, CO 80303-1050 2018-07-19
1316469711 Bouldent, LLC Clinic/Center 4550 Broadway St Unit C-3e, Boulder, CO 80304-4801 2017-07-07
1396131306 Judith Timchula Dds, PC Clinic/Center 7490 Clubhouse Rd, Suite 101, Boulder, CO 80301-3720 2015-04-07
1164036166 Peakview Dentistry Pllc Clinic/Center 1200 28th St Ste 300, Boulder, CO 80303-1756 2020-09-07
1649733585 Great Smiles Dentistry, LLC Clinic/Center 1656 30th St, Boulder, CO 80301-1014 2019-04-08
1790141539 Integrity Dental of Boulder, Ltd Clinic/Center 777 29th St, Ste. #300, Boulder, CO 80303-2358 2016-01-09
1942687926 Jeffrey H Wong, D.d.s. M.s. Clinic/Center 3400 Penrose Pl, Suite 203, Boulder, CO 80301-1809 2015-04-29
1740546100 Elkhorn Family Dental, LLC Clinic/Center 211 North Main Street, Boulder, MT 59632-0512 2012-04-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1528669074 Red House Clinic/Center 440 S Lincoln Ave Ste B10, Steamboat Springs, CO 80487-8935 2020-11-02
1881294387 Scott Holm Dmd Pllc Clinic/Center 685 Citadel Dr E Ste 200b, Colorado Springs, CO 80909-5315 2020-10-26
1205435013 Kids In Need of Dentistry Clinic/Center 4201 E 72nd Ave Unit D, Commerce City, CO 80022-1578 2020-10-22
1619576428 Kids In Need of Dentistry Clinic/Center 925 N Lincoln St Ste B, Denver, CO 80203-2784 2020-10-22
1477151173 Professional Dental Care of New Mexico Clinic/Center 10233 S Parker Rd Ste 107, Parker, CO 80134-9314 2020-10-14
1023615556 Vida Orthodontics Clinic/Center 19551 Hess Rd Unit 110, Parker, CO 80134-3446 2020-10-07
1417554668 Turner, Pllc Clinic/Center 5361 S Gray St, Denver, CO 80123-5110 2020-10-01
1316553860 Willow Creek Perfect Teeth PC Clinic/Center 8150 S Quebec St Ste C, Centennial, CO 80112-3186 2020-09-21
1326653841 Nic - Denver, Pllc Clinic/Center 8000 E Prentice Ave Ste A3, Greenwood Village, CO 80111-2725 2020-09-11
1568075489 Open and Affordable Dental Cs North Pllc Clinic/Center 6375 Lehman Dr Ste 200, Colorado Springs, CO 80918-1427 2020-08-29
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Competitor

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City BOULDER
Zip Code 80301

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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