DR. JOHN R DODGE (NPI# 1629190194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629190194 |
| Entity Type | Individual |
| Full Name | DR. JOHN R DODGE |
| Credential | DMD,MS |
| Practice Address |
1440 28th St Suite 1 Boulder CO 80303-1030 |
| Practice Telephone | 3034470460 |
| Practice Fax Number | 3034479578 |
| Mailing Telephone | 3034470460 |
| Mailing Fax Number | 3034479578 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
CO7489 | CO | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770503153 | John S Dodge | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2006-07-20 |
| 1770510489 | John M Dodge | Internal Medicine | 501 Washington St, Suite 600, San Diego, CA 92103-2231 | 2006-06-27 |
| Street Address |
1440 28TH ST SUITE 1 |
| City | BOULDER |
| State | CO |
| Zip Code | 80303-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790877637 | Kelly Jacobs Parcell | Naturopath | 1440 28th St, Suite 4, Boulder, CO 80303-1030 | 2006-09-28 |
| 1689978637 | Ian M Kott Dds PC | Dentist | 1440 28th St, Suite 1, Boulder, CO 80303-1030 | 2011-01-05 |
| 1700042850 | Brock Westover, D.d.s., M-ed, Pllc | Dentist | 1440 28th St, Suite 3, Boulder, CO 80303-1030 | 2008-07-29 |
| 1225207129 | Daniel B. Foley, D.d.s., P.C. | Oral & Maxillofacial Surgery | 1440 28th St, Suite 2, Boulder, CO 80303-1030 | 2008-02-25 |
| 1245445667 | Colorado Sleep Company | Clinic/Center | 1440 28th St, Ste 4, Boulder, CO 80303-1030 | 2007-05-11 |
| 1568585479 | Gregg T Rogers | Dentist | 1440 28th St, Suite 1, Boulder, CO 80303-1030 | 2007-04-06 |
| 1851433932 | Daniel B Foley | Dentist | 1440 28th St, Ste. 2, Boulder, CO 80303-1030 | 2007-02-13 |
| 1144397662 | Robert James Kammer Jr. | Dentist | 1440 28th St, Suite 3, Boulder, CO 80303 | 2006-11-29 |
| 1215009220 | Ian Michael Kott | Dentist | 1440 28th St, Suite 1, Boulder, CO 80303-1030 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821583725 | Ariel Meyers | Physical Therapist | Frasier Meadows Retirement Community Dept. of Rehab, 350 Ponca Place, Boulder, CO 80303 | 2018-06-25 |
| 1831683838 | Sandra Ramsey | Occupational Therapist | 350 Ponca, Boulder, CO 80303 | 2018-06-22 |
| 1770085243 | Laura Michelle Boucher | Physical Medicine & Rehabilitation | 5387 Manhattan Cir, Ste 200, Boulder, CO 80303 | 2018-03-01 |
| 1396255568 | Colorado Sports Chiropractic | Chiropractor | 1440 28th St Ste 2, Boulder, CO 80303 | 2017-10-02 |
| 1932618782 | Michele Adrienne Packard | Psychologist | 4410 Arapahoe Suite 140, Boulder, CO 80303 | 2017-09-25 |
| 1134505290 | Bili Blanket Baby, LLC | Durable Medical Equipment & Medical Supplies | 4450 Arapahoe Ave, Suite 100, Boulder, CO 80303 | 2015-07-30 |
| 1710378146 | Jonathan Gardiner Lears | Counselor | 5600 Arapahoe Ave, Suite 102, Boulder, CO 80303 | 2015-02-06 |
| 1114316965 | Northstar Transitions | Substance Abuse Rehabilitation Facility | 75 Manhattan Dr., Suites 110 and 208 Northstar Transitions, Boulder, CO 80303 | 2015-01-16 |
| 1902226434 | Integrated Dermatology of Boulder, Pllc | Dermatology | 2935 Baseline Road, Suite 201, Boulder, CO 80303 | 2014-04-23 |
| 1396160081 | Melissa Rupert | Physical Therapist | 975 Waite Drive, Boulder, CO 80303 | 2014-03-04 |
| Find all providers in zip 80303 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215413356 | Brian Lehigh | Dentist | 3400 Penrose Pl Ste 103, Boulder, CO 80301-1809 | 2018-07-12 |
| 1720137110 | Giles Brian Horrocks | Dentist | 3400 Penrose Place, #103, Boulder, CO 80301 | 2007-01-09 |
| 1174603963 | Dyeus M Chung | Dentist | 1840 Folsom St Ste 302, Boulder, CO 80302-5712 | 2006-10-16 |
| 1568585479 | Gregg T Rogers | Dentist | 1440 28th St, Suite 1, Boulder, CO 80303-1030 | 2007-04-06 |
| 1891830931 | Vermon Craig Barney | Dentist | 211 North Main, Boulder, MT 59632 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013551530 | Greenwood Village Dental LLC | Dentist | 8000 E Prentice Ave Ste D7, Greenwood Village, CO 80111-2728 | 2019-10-29 |
| 1144878521 | Partners In Periodontics Pllc | Dentist | 1625 Foxtrail Dr Ste 100, Loveland, CO 80538-9089 | 2019-08-29 |
| 1114485331 | Joseph K Will Dds Ms Pllc | Dentist | 10050 W 41st Ave Unit 201, Wheat Ridge, CO 80033-4123 | 2019-03-06 |
| 1295270916 | Veronica Longville | Dentist | 13533 Huron St Ste 300, Westminster, CO 80234-1160 | 2017-01-04 |
| 1801204532 | Saroj Kumar Saha | Dentist | 682 S Emerson St, Denver, CO 80209-4339 | 2014-07-25 |
| 1053727024 | Mccombs Periodontics LLC | Dentist | 13335 Voyager Pkwy, Suite 130, Colorado Springs, CO 80921-7657 | 2014-07-10 |
| 1992129456 | Daryl Jorge Gasca | Dentist | 6900 W Grant Ranch Blvd, Littleton, CO 80123-5161 | 2014-02-04 |
| 1346663622 | Angie Lee, Dmd, Ms, Pllc | Dentist | 1220 Oak Park Dr Ste 2, Fort Collins, CO 80525-7302 | 2014-01-22 |
| 1629414677 | Colorado Gum Care | Dentist | 899 Hwy 287, Suite 100, Broomfield, CO 80020-7005 | 2013-05-17 |
| 1780948794 | Tyler Dale Borg | Dentist | 11178 Huron St Ste 100, Northglenn, CO 80234-3115 | 2012-06-25 |
| 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.