Experience Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EXPERIENCE DENTAL PLLC

Practice address

1933 28TH St Ste 204
Boulder, CO 80301-1100

Phone

(720) 645-1226

NPI assigned

Sep 23, 2019

Last updated

Jun 15, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeremy Richard Altdorfer, DDSNPI 1780235713

Title

Ceo

Phone

(720) 645-1226

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeremy Richard Altdorfer, DDS

  • General Practice Dentistry
  • Boulder, CO
  • NPI 1780235713
  NPD Authorized official
• Adam Altdorfer, DDS

  • General Practice Dentistry
  • Boulder, CO
  • NPI 1235667494
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1013568963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 28TH ST STE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011100",
            "telephone_number": "720-645-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 28TH ST STE 204",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011100",
            "telephone_number": "720-645-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "ALTDORFER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-645-1226",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evolve in Nature
• Mary E Ewers-Dennison, OTR, CHT
• Peter C Ewing, M.D.
• Expand Mentoring LLC
• Experience Dental Hygiene Practice 1 LLC (Experience Dental Hygiene)
• Eye Center of Northern Colorado, P.C (Boulder Eye Surgeons, P.C.)
• Eye Center of Northern Colorado, P.C (Boulder Eye Surgeons PC)
• Eye on Living, Inc.
• Ashley Eyre
• Landrey Fagan, MD

• Dental Clinic/Center in Boulder, CO
• Providers in Boulder, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.