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1275251381 NPI number — MILE HIGH DENTAL ANESTHESIA LLC

NPI Number: 1275251381
Health Care Provider/Practitioner: MILE HIGH DENTAL ANESTHESIA LLC

Information about “1275251381” NPI (MILE HIGH DENTAL ANESTHESIA LLC) exists in 1275251381 in HTML format HTML  |  1275251381 in plain Text format TXT  |  1275251381 in PDF (Portable Document Format) PDF  |  1275251381 in an XML format XML  formats.

NPI Number : 1275251381 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275251381",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MILE HIGH DENTAL ANESTHESIA LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11001 W 120TH AVE STE 400",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BROOMFIELD",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80021-3493",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11001 W 120TH AVE STE 400",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BROOMFIELD",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80021-3493",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "970-315-1319",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/16/2022",
    "LastUpdateDate": "08/16/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "REES",
    "AuthorizedOfficialFirstName": "REBECCA",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "DENTIST ANESTHESIOLOGIST/OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "720-315-1319",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223D0004X",
        "TaxonomyName": "Dental Anesthesiology",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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