Healthcare Provider Details

I. General information

NPI: 1366065674
Provider Name (Legal Business Name): SOUTH DENVER SURGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W DRY CREEK CIR STE 120
LITTLETON CO
80120-8078
US

IV. Provider business mailing address

11 W DRY CREEK CIR STE 120
LITTLETON CO
80120-8078
US

V. Phone/Fax

Practice location:
  • Phone: 303-835-1129
  • Fax: 303-835-1192
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTY CHRISTOPHER
Title or Position: LEADER OF THE PCM BILLING TEAM
Credential: RN
Phone: 214-673-5147