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General NPI Number Information
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NPI Number | 1235870312
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Entity Type | Individual
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Provider Name | JEREMY DEAN
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Gender | Male
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 4500 E 9TH AVE STE 320
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City | DENVER
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State | CO
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Zip | 80220-3922
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Country | US
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Telephone | 303-322-0212
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0072021
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License Number State | CO
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