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General NPI Number Information
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NPI Number | 1558801852
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Entity Type | Individual
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Provider Name | JEFFREY JOSEPH BIRG D.D.S, M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 14422 ORCHARD PKWY STE 200
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City | WESTMINSTER
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State | CO
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Zip | 80023-9273
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Country | US
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Telephone | 303-452-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 14422 ORCHARD PKWY STE 200
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City | WESTMINSTER
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State | CO
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Zip | 80023-9273
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Country | US
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Telephone | 303-452-0811
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2901022122
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DEN.00203736
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License Number State | CO
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