BOULDER MODERN DENTISTRY LLP NPI 1104130293

NPI Information

  • NPI: 1104130293
  • Provider Name: BOULDER MODERN DENTISTRY, LLP
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: BOULDER MODERN DENTISTRY
  • Address: 2100 28TH ST STE 4F
    BOULDER, CO
    ZIP 80301
  • Phone: (303) 442-4455

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NPI Details

BOULDER MODERN DENTISTRY, LLP is a general practice dentist in Boulder, CO. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BOULDER MODERN DENTISTRY, LLP NPI is 1104130293. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Boulder Modern Dentistry.

The provider's business location address is:

2100 28TH ST STE 4F
BOULDER, CO
ZIP 80301-106
Phone: (303) 442-4455
Fax: (303) 443-0972

The provider's authorized official is William J Mcglashan .
The authorized official title is Contracts Admin and has the following contact phone number (303) 442-4455.

The enumeration date for this NPI number is 7/30/2010 and was last updated on 7/30/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

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: 3/30/2025

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