ANDREW LIONEL FISCUS (NPI# 1902805138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902805138 |
| Entity Type | Individual |
| Full Name | ANDREW LIONEL FISCUS |
| Credential | DDS |
| Practice Address |
3400 Penrose Pl Suite 202 Boulder CO 80301-1809 |
| Practice Telephone | 3034425748 |
| Practice Fax Number | 3034425749 |
| Mailing Telephone | 3034425748 |
| Mailing Fax Number | 3034425749 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/20/2006 |
| NPI Reactivation Date | 2006-04-11 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
8195 | CO | Dental Providers |
| Street Address |
3400 PENROSE PL SUITE 202 |
| City | BOULDER |
| State | CO |
| Zip Code | 80301-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942687926 | Jeffrey H Wong, D.d.s. M.s. | Clinic/Center | 3400 Penrose Pl, Suite 203, Boulder, CO 80301-1809 | 2015-04-29 |
| 1043606510 | Lopez Dental Health Group PC | Dentist | 3400 Penrose Pl, Boulder, CO 80301-1809 | 2015-04-12 |
| 1205064151 | Kenneth W Mickens II | Dentist | 3400 Penrose Pl, Suite 101, Boulder, CO 80301-1809 | 2009-06-30 |
| 1629239827 | John Montoya Dds PC | Dentist | 3400 Penrose Pl, Suite 104, Boulder, CO 80301-1809 | 2008-06-19 |
| 1063683365 | Edward E Barrett Dds | Dentist | 3400 Penrose Pl, Suite 104, Boulder, CO 80301 | 2008-03-14 |
| 1477766178 | Markowitz & Wong Orthodontics | Dentist | 3400 Penrose Pl, Suite 203, Boulder, CO 80301-1809 | 2007-05-08 |
| 1912110693 | Jeffrey H Wong | Dentist | 3400 Penrose Pl, Suite 203, Boulder, CO 80301-1809 | 2007-05-08 |
| 1780800581 | Andrew R Johann | Dentist | 3400 Penrose Pl, Suite 102, Boulder, CO 80301-1809 | 2007-04-18 |
| 1194941625 | Robert Holden | Dentist | 3400 Penrose Pl, Suite 202, Boulder, CO 80301-1809 | 2007-04-17 |
| 1750413316 | Edward E Barrett | Dentist | 3400 Penrose Pl, Suite #104, Boulder, CO 80301-1809 | 2007-03-09 |
| Find all providers in the same location | ||||
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336751213 | Michael Kawulok | Dentist | 5221 Pinehurst Dr, Boulder, CO 80301-3792 | 2020-08-20 |
| 1780235713 | Jeremy Richard Altdorfer | Dentist | 1933 28th St Ste 204, Boulder, CO 80301-1100 | 2019-09-20 |
| 1538688908 | Kyle N. Daniel Dds PC | Dentist | 2830 Valmont Rd, Boulder, CO 80301 | 2017-09-16 |
| 1508243775 | Alyssa Ellsworth | Dentist | 4150 Darley Ave Ste 3, Boulder, CO 80305-6537 | 2015-04-27 |
| 1982008546 | Kenneth Warren Ostrov | Dentist | 661 S Broadway St, Boulder, CO 80305-5926 | 2014-10-10 |
| 1952718553 | David P. Stangl, Jr., Dmd, Professional LLC | Dentist | 2880 Folsom St Ste 202, Boulder, CO 80304-3769 | 2014-07-15 |
| 1497098974 | Andrea Irarrazabal | Dentist | 3216 Arapahoe Ave, Boulder, CO 80303-1043 | 2013-04-02 |
| 1770835118 | Gary Raymond Hubiak | Dentist | 810 36th St, Boulder, CO 80303-2440 | 2012-10-09 |
| 1427316215 | Anil P Nutakki | Dentist | 1840 Folsom St Ste 301, Boulder, CO 80302-5712 | 2012-04-30 |
| 1457661647 | Corbett W Summers Dds | Dentist | 777 29th St., Suite 300, Boulder, CO 80303 | 2010-10-21 |
| Find all providers in BOULDER | ||||
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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.