MEDICARE: DENTAL ACCESS ADMINISTRATORS

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	3642	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	:	1992707954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL ACCESS ADMINISTRATORS

Provider Business Mailing Address
First Line	:	1717 YORK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1212
Country	:	US
Telephone Number	:	303-394-0231
Fax Number	:	303-329-4622

Provider Business Practice Location Address
First Line	:	1717 YORK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1212
Country	:	US
Telephone Number	:	303-394-0231
Fax Number	:	303-329-4622

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAJOR WILLIAM TAPPAN
Credential	:	D.D.S.
Telephone Number	:	303-394-0231

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	08/22/2020

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