Healthcare Provider Details

I. General information

NPI: 1104051473
Provider Name (Legal Business Name): RYAN NATHANIEL DOBBS D.D.S., M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 05/11/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7380 SOUTH GARTRELL ROAD
AURORA CO
80016
US

IV. Provider business mailing address

7380 SOUTH GARTRELL ROAD
AURORA CO
80016
US

V. Phone/Fax

Practice location:
  • Phone: 720-826-8900
  • Fax: 720-826-8899
Mailing address:
  • Phone: 720-826-8900
  • Fax: 720-826-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6630
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number202453
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDS039194
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberA118747
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number55063
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: