Healthcare Provider Details

I. General information

NPI: 1972830388
Provider Name (Legal Business Name): JASON KIRK READ DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 S BEELER ST # 3
DENVER CO
80237-1833
US

IV. Provider business mailing address

3660 S BEELER ST #3
DENVER CO
80237-1833
US

V. Phone/Fax

Practice location:
  • Phone: 662-769-1614
  • Fax:
Mailing address:
  • Phone: 662-769-1614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN.00202181
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: