AESTHETIC & MAXILLOFACIAL ASSOCIATES (NPI# 1083868988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083868988 |
| Entity Type | Organization |
| Organization Name | AESTHETIC & MAXILLOFACIAL ASSOCIATES |
| Practice Address |
1610 Canyon Blvd Boulder CO 80302-5407 |
| Practice Telephone | 3039380130 |
| Practice Fax Number | 3032450405 |
| Mailing Telephone | 3039380130 |
| Mailing Fax Number | 3032450405 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-18 |
| Authorized Official Name | DR. PAUL CHARLES MADLOCK (DOCTOR) |
| Authorized Official Telephone | 7208788999 |
| Authorized Official Credential | MD, DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | AESTHETIC & MAXILLOFACIAL ASSOCIATES LLC | 1610 Canyon Blvd, 3020 Carbon Place #102, Boulder, CO 80302 |
| Street Address |
1610 CANYON BLVD |
| City | BOULDER |
| State | CO |
| Zip Code | 80302-5407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609812999 | Donovan Troy Martin | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2006-06-22 |
| 1588166318 | Margo Kathryn Nagel | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2018-03-07 |
| 1871839621 | Flatirons Dental Center, PC | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2012-12-26 |
| 1134447857 | Boulder Dental Center, P.c | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2010-05-05 |
| 1285811679 | Danny Abboud | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2008-01-28 |
| 1154331023 | Walter Sellers Davis | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323347 | Aviva Naomi Bannerman | Counselor | 2299pearlst., Boulder, CO 80302 | 2020-07-22 |
| 1205480845 | Mark L Sipowicz | Counselor | 100 Arapahoe Avenue, Boulder, CO 80302 | 2019-08-01 |
| 1366909806 | Brett Adamek | Counselor | 2027 Broadway, Suite E, Boulder, CO 80302 | 2019-02-20 |
| 1124592225 | Stepheny Antrobus | Counselor | 100 Arapahoe Lane, Suite 12, Boulder, CO 80302 | 2019-01-11 |
| 1942721337 | Sasha Marvel Hope | Nutritionist | 2260 Baseline Road #102, Boulder, CO 80302 | 2017-07-06 |
| 1073045365 | Mark Shusterman | Internal Medicine | 2133 5th Street, Boulder, CO 80302 | 2017-03-28 |
| 1316489396 | Agnieszka Spuzak | Nutritionist | 1267 Fourmile Canyon Dr, Boulder, CO 80302 | 2016-11-08 |
| 1265980031 | Tanya Robertson | Physical Therapy Assistant | 1633 Grove Street, Boulder, CO 80302 | 2016-09-21 |
| 1699142380 | Libbey Occupational Therapy Services LLC | Occupational Therapist | 100 West Arapahoe Ln, Suite 12, Boulder, CO 80302 | 2015-08-28 |
| 1831597244 | Annemarie Curran Prairie | Counselor | 2505 Walnut St., Ste 303, Boulder, CO 80302 | 2014-12-17 |
| Find all providers in zip 80302 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467967307 | Boulder Oral Surgery | Dentist | 3450 Penrose Pl Ste 120, Boulder, CO 80301-1800 | 2017-12-13 |
| 1306113261 | Peter Frederick Steinhauer | Dentist | 7492 Spring Dr, Boulder, CO 80303-5120 | 2011-11-21 |
| 1447493309 | Benjamin Daniel Foley | Dentist | 1420 28th St Ste 100, Boulder, CO 80303-1081 | 2009-04-08 |
| 1366601486 | Thien-thao Thi Le | Dentist | 1840 Folsom St Ste 304, Boulder, CO 80302-5712 | 2008-06-04 |
| 1477761062 | Terrence R Nedbalski | Dentist | 3450 Penrose Pl, Ste #120, Boulder, CO 80301-1828 | 2007-05-18 |
| 1851433932 | Daniel B Foley | Dentist | 1440 28th St, Ste. 2, Boulder, CO 80303-1030 | 2007-02-13 |
| 1033287115 | Lonnie M Sibley Jr. | Dentist | 4155 Darley Ave, Boulder, CO 80305-6536 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071189 | Oms Associates Colorado PC | Dentist | 755 Maleta Ln Ste A, Castle Rock, CO 80108-7610 | 2020-10-26 |
| 1346849866 | Oms Associates Colorado PC | Dentist | 1755 Telstar Dr Ste 210, Colorado Springs, CO 80920-1018 | 2020-10-26 |
| 1740889260 | Oms Associates Colorado PC | Dentist | 10219 Parkglenn Way Ste 201, Parker, CO 80138-3875 | 2020-10-26 |
| 1386266070 | Blue Sky Oms P.C. | Dentist | 1707 61st Ave Ste 102, Greeley, CO 80634-7997 | 2020-05-15 |
| 1679121404 | James W Makowski Dds PC | Dentist | 1220 S Parker Rd Ste 104, Denver, CO 80231-2166 | 2019-08-26 |
| 1528553070 | Comfort Dental Oral Surgery Colorado Springs LLC | Dentist | 556 W. Hwy 105, Monument, CO 80132 | 2018-06-27 |
| 1689167280 | Cheyenne Mountain Oral Surgery PC | Dentist | 640 Southpointe Ct Ste 150, Colorado Springs, CO 80906-3884 | 2018-06-08 |
| 1932692589 | Glendale Oral Surgery PC | Dentist | 3955 E Exposition Ave Ste 520, Denver, CO 80209-5030 | 2018-06-08 |
| 1790292431 | Alix Greenman | Dentist | 6179 S Balsam Way Ste 100, Littleton, CO 80123-3092 | 2018-01-03 |
| 1467964858 | David Andrew Benson, Dds, Pllc | Dentist | 6160 Tutt Blvd Ste 250, Colorado Springs, CO 80923-1500 | 2017-10-25 |
| 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.