Healthcare Provider Details

I. General information

NPI: 1487499794
Provider Name (Legal Business Name): WESTERN SINUS AND SKULL BASE CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 E 3RD AVE STE 300
DENVER CO
80206-5247
US

IV. Provider business mailing address

191 UNIVERSITY BLVD STE 251
DENVER CO
80206-4613
US

V. Phone/Fax

Practice location:
  • Phone: 720-899-9489
  • Fax:
Mailing address:
  • Phone: 720-530-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD J HEPWORTH
Title or Position: OWNER/OFFICER
Credential: MD
Phone: 720-899-9489