MEDICARE: DR. JEFFREY LOBERG DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019029151	IL
2	1223E0200X	Endodontics	019029151	IL
3	1223E0200X	Endodontics	DEN.00205893	CO
4	1223E0200X	Endodontics	4250-21	MS

General Provider Information

NPI Number	:	1033468269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY LOBERG DMD

Provider Business Mailing Address
First Line	:	10200 E GIRARD AVE STE A205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5503
Country	:	US
Telephone Number	:	303-745-9200
Fax Number	:	303-752-3645

Provider Business Practice Location Address
First Line	:	10200 E GIRARD AVE STE A205
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5503
Country	:	US
Telephone Number	:	303-745-9200
Fax Number	:	303-752-3645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2012
Last Update Date	:	04/20/2026

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