Healthcare Provider Details

I. General information

NPI: 1295657757
Provider Name (Legal Business Name): FOUNDATION DENTAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 MAIN ST
LONGMONT CO
80501-2035
US

IV. Provider business mailing address

16579 PEAK WAY
BROOMFIELD CO
80023-6708
US

V. Phone/Fax

Practice location:
  • Phone: 630-677-7501
  • Fax:
Mailing address:
  • Phone: 630-677-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: COLIN HIRSCH
Title or Position: OWNER
Credential: DDS
Phone: 630-677-7501