Healthcare Provider Details

I. General information

NPI: 1922903277
Provider Name (Legal Business Name): PARKER ORAL SURGERY AND IMPLANT CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19700 E PARKER SQUARE DR
PARKER CO
80134-7301
US

IV. Provider business mailing address

19700 E PARKER SQUARE DR
PARKER CO
80134-7301
US

V. Phone/Fax

Practice location:
  • Phone: 303-840-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JULIA PLEVNIA
Title or Position: OWNER
Credential:
Phone: 303-840-2300