MEDICARE: EVERGREEN DENTAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	HD104930	CO

General Provider Information

NPI Number	:	1215104336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGREEN DENTAL GROUP

Provider Business Mailing Address
First Line	:	31226 LEWIS RIDGE RD
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7998
Country	:	US
Telephone Number	:	303-674-5566
Fax Number	:	303-674-8911

Provider Business Practice Location Address
First Line	:	31226 LEWIS RIDGE RD
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-7998
Country	:	US
Telephone Number	:	303-674-5566
Fax Number	:	303-674-8911

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DONALD SHARP
Credential	:
Telephone Number	:	303-674-5566

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

Similar Medicare Providers

1376540880 — DR. DONALD G. SHARP DDS
Practice Location Address:

31226 LEWIS RIDGE RD
EVERGREEN, CO
80439-7998

Practice Phone: 303-674-5566
Practice Fax: 303-674-8911

1922124049 — JEFFREY JAMES SPROUT DDS
Practice Location Address:

31226 LEWIS RIDGE RD
EVERGREEN, CO
80439-7998

Practice Phone: 303-674-5566
Practice Fax: 303-674-8911

1700902574 — BEVERLY KEELER SPROUT DDS
Practice Location Address:

31226 LEWIS RIDGE RD
EVERGREEN, CO
80439-7998

Practice Phone: 303-674-5566
Practice Fax: 303-674-8911

1518122118 — DR. ROBERT SCOTT GORDON DMD
Practice Location Address:

2902 EVERGREEN PARKWAY
EVERGREEN, CO
80439-7998

Practice Phone: 303-674-5566
Practice Fax:

1477819894 — DR. NATHAN P CHEROF D.M.D.
Practice Location Address:

31226 LEWIS RIDGE RD
EVERGREEN, CO
80439-7998

Practice Phone: 303-674-5566
Practice Fax:

1093711848 — MICHAEL JOE LARSON D.D.S.
Practice Location Address:

30940 STAGECOACH BLVD , STE E250
EVERGREEN, CO
80439-7984

Practice Phone: 303-674-6777
Practice Fax:

Directions to “EVERGREEN DENTAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.