MEDICARE: JLS MANAGEMENT LLC

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	1223P0221X	Pediatric Dentistry	0651	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184848194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLS MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	2789 W ALAMEDA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-3042
Country	:	US
Telephone Number	:	303-935-1705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2789 W ALAMEDA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-3042
Country	:	US
Telephone Number	:	303-935-1705
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JONATHAN STRANGE
Credential	:
Telephone Number	:	303-935-1705

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	08/22/2020

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Directions to “JLS MANAGEMENT LLC ” Practice Location

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