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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306456421 | Experience Dental Pllc | Clinic/Center | 7001 S Custer Rd, Ste 200, Mckinney, TX 75070-7507 | 2020-08-04 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Experience Dental PLLC | 1933 28th Street, Suite 204, Boulder, CO 80301 |
Street Address |
1933 28TH ST STE 204 |
City | BOULDER |
State | CO |
Zip Code | 80301-1100 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780235713 | Jeremy Richard Altdorfer | Dentist | 1933 28th St Ste 204, Boulder, CO 80301-1100 | 2019-09-20 |
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 |
Find all providers in zip 80301 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
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 |
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 |
Find all providers with the same taxonomy |
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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.