Active NPI
Byford Thomas Jarvis, DDS
- Dentist
- Broomfield, CO
National Provider Identifier
1104944552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6136
- Practice address
- 6363 W 120TH Ave
Suite 205
Broomfield, CO 80020 - Phone
- (303) 466-4660
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6136 | CO | Primary |
Addresses
Primary practice location
6363 W 120TH Ave
Suite 205
Broomfield, CO 80020
Mailing address
6363 W 120TH Ave
Suite 205
Broomfield, CO 80020
Phone (303) 466-4660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 1, 2016 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6136 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104944552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6363 W 120TH AVE",
"address_2": "SUITE 205",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "80020",
"telephone_number": "303-466-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6363 W 120TH AVE",
"address_2": "SUITE 205",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "80020",
"telephone_number": "303-466-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "BYFORD",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "6136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.