DR. JASON PRUETT DDS NPI 1770212409

NPI Information

NPI: 1770212409
Provider Name: DR. JASON PRUETT, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
4550 BROADWAY ST
BOULDER, CO
ZIP 80304
Phone: (801) 386-8696
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DR. Jason Pruett, DDS 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. DR. Jason Pruett, DDS NPI is 1770212409. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4550 BROADWAY ST
BOULDER, CO
ZIP 80304-801
Phone: (801) 386-8696

The enumeration date for this NPI number is 6/8/2022 and was last updated on 5/16/2023.

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
1	122300000X	Dentist		12886440-9923	UTAH	No
2	1223G0001X	Dentist	General Practice	DEN.00205216	COLORADO	Yes

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

NPI Synchronization or Removal

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