Individual provider Active NPI

Neil Neugeboren, D.D.S.

  • Periodontics
  • Denver, CO
National Provider Identifier
1114025160
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8231 Issued in CO
Practice address
10200 E Girard Ave
Suite a- 209
Denver, CO 80231-5500
Phone
(303) 695-0990
Fax
(303) 695-6915
NPI assigned
Sep 20, 2006
Last updated
Nov 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8231 CO Primary

Addresses

Primary practice location

10200 E Girard Ave
Suite a- 209
Denver, CO 80231-5500

Mailing address

3690S Yosemite St
Denver, CO 80237-1808
Phone (303) 695-0990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111000629 CO Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 7416267083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8231COMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Altura Periodontics Periodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1114025160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690S YOSEMITE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371808",
            "telephone_number": "303-695-0990",
            "fax_number": "303-695-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 E GIRARD AVE",
            "address_2": "SUITE A- 209",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802315500",
            "telephone_number": "303-695-0990",
            "fax_number": "303-695-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUGEBOREN",
        "first_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.