Advanced Dental Center
Organization Active NPI General Practice Dentistry · Federal Heights, CO
NPI 1467868596 · NPPES record last updated Sep 16, 2015
Key facts
- NPI
- 1467868596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8478 (CO)
- Legal business name
- ADVANCED DENTAL CENTER
- Practice address
- 1557 W 84TH Ave Unit 1
Federal Heights, CO 80260-4780 - Phone
- (303) 426-4860
- Fax
- (303) 426-1530
- NPI assigned
- Jul 9, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason Ronald Van Wagenen
- Title
- Partner
- Phone
- (303) 426-4860
National Provider Directory
Locations
1557 W 84th Ave
Unit 1
Federal Heights, CO 80260
Phone (303) 426-4860
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 8478 | CO | Yes |
Addresses
Primary practice location
1557 W 84TH Ave Unit 1
Federal Heights, CO 80260-4780
Mailing address
1557 W 84TH Ave Unit 1
Federal Heights, CO 80260-4780
Phone (303) 426-4860
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98681753 | Medicaid | CO |
Other providers in Federal Heights, CO
- 1918 Winter Street Operating Co LLC
- Arthur Dee Abercrombie
- Addo Home Health Care,Inc
- Advanced Dental Center, PLLC
- Lori Ann Aichele
- Ashlynn Ammerman
- Elyssabeth Beers
- Stacie Benson
All providers in Federal Heights, CO · General Practice Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.