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SOUTH GREELEY PROF. LLC NPI 1053811463


NPI Information

NPI: 1053811463
Provider Name: SOUTH GREELEY, PROF. LLC

Doing Business As: COMFORT DENTAL SOUTH GREELEY

Classification: Dentist - 122300000X
Entity Type: Organization
Address:
2716 11TH AVE
GREELEY, CO
ZIP 80631
Phone: (970) 673-4310
Get Directions

SOUTH GREELEY, PROF. LLC is a dentist in Greeley, CO. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. SOUTH GREELEY, PROF. LLC NPI is 1053811463. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Comfort Dental South Greeley.

The provider's business location address is:

2716 11TH AVE
GREELEY, CO
ZIP 80631-443
Phone: (970) 673-4310

The provider's authorized official is Jarum Boyer .
The authorized official title is Dentist/owner and has the following contact phone number (970) 673-4310.

The enumeration date for this NPI number is 2/13/2018 and was last updated on 2/13/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist9766COLORADOYes
2122300000XDentist10437COLORADONo
3122300000XDentist10703COLORADONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11063555043OTHERCOLORADONPI
249032551MEDICAIDCOLORADO
349305832MEDICAIDCOLORADO
41285814772OTHERCOLORADONPI
550472721MEDICAIDCOLORADO
61720371404OTHERCOLORADONPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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