BOULDER ORAL SURGERY (NPI# 1467967307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467967307 |
| Entity Type | Organization |
| Organization Name | BOULDER ORAL SURGERY |
| Other Organization Name | BOULDER ORAL SURGERY |
| Practice Address |
3450 Penrose Pl Ste 120 Boulder CO 80301-1800 |
| Mailing Address |
3450 Penrose Pl Suite 120 Boulder CO 80301-1800 |
| Practice Telephone | 3034479735 |
| Practice Fax Number | 3034479735 |
| Mailing Telephone | 3034479735 |
| Mailing Fax Number | 3034471025 |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. TERRENCE ROBERT NEDBALSKI (OWNER) |
| Authorized Official Telephone | 3034479735 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | TERRENCE NEDBALSKI DDS PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9410 | CO | Dental Providers |
| Other Name | Type Code |
|---|---|
| Boulder Oral Surgery | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1325 Hover St Ste 101, Longmont, CO 805013137 | 3037728585 | 3037764895 |
| Street Address |
3450 PENROSE PL STE 120 |
| City | BOULDER |
| State | CO |
| Zip Code | 80301-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031454 | Jonathan William Garson | Social Worker | 1790 30th St., Boulder, CO 80301 | 2020-10-20 |
| 1164048161 | Crossroads Medical Center | Family Medicine | 2760 29th St., Suite 28, Boulder, CO 80301 | 2020-06-25 |
| 1316585045 | Karissa Marlene Smith | Registered Nurse | 4770 Pearl Street, Suite A, Boulder, CO 80301 | 2019-12-12 |
| 1184273864 | National Doula Network | Doula | 5918 Gunbarrel Ave Apt E, Boulder, CO 80301 | 2019-09-05 |
| 1861047086 | Samuel Shay | Chiropractor | 1750 30th St, Ste 1, #226, Boulder, CO 80301 | 2019-08-05 |
| 1124504808 | Be Free Live Now LLC | Social Worker | 2945 Center Creen Court, Suite G211, Boulder, CO 80301 | 2018-07-16 |
| 1720596703 | Janis Dochterman | Counselor | 5378 Sterling Drive, Studio #3, Boulder, CO 80301 | 2018-01-12 |
| 1033628631 | Whitney Shea | Physical Therapy Assistant | 3020 Carbon Place, #330, Physical Therapy of Boulder, Boulder, CO 80301 | 2017-09-26 |
| 1538688908 | Kyle N. Daniel Dds PC | Dentist | 2830 Valmont Rd, Boulder, CO 80301 | 2017-09-16 |
| 1497205231 | Jenna Orosco | Counselor | 2945 Center Green Ct. Suite H, Suite H, Boulder, CO 80301 | 2016-10-05 |
| Find all providers in zip 80301 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306113261 | Peter Frederick Steinhauer | Dentist | 7492 Spring Dr, Boulder, CO 80303-5120 | 2011-11-21 |
| 1447493309 | Benjamin Daniel Foley | Dentist | 1420 28th St Ste 100, Boulder, CO 80303-1081 | 2009-04-08 |
| 1366601486 | Thien-thao Thi Le | Dentist | 1840 Folsom St Ste 304, Boulder, CO 80302-5712 | 2008-06-04 |
| 1083868988 | Aesthetic & Maxillofacial Associates | Dentist | 1610 Canyon Blvd, Boulder, CO 80302-5407 | 2008-11-05 |
| 1477761062 | Terrence R Nedbalski | Dentist | 3450 Penrose Pl, Ste #120, Boulder, CO 80301-1828 | 2007-05-18 |
| 1851433932 | Daniel B Foley | Dentist | 1440 28th St, Ste. 2, Boulder, CO 80303-1030 | 2007-02-13 |
| 1033287115 | Lonnie M Sibley Jr. | Dentist | 4155 Darley Ave, Boulder, CO 80305-6536 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071189 | Oms Associates Colorado PC | Dentist | 755 Maleta Ln Ste A, Castle Rock, CO 80108-7610 | 2020-10-26 |
| 1346849866 | Oms Associates Colorado PC | Dentist | 1755 Telstar Dr Ste 210, Colorado Springs, CO 80920-1018 | 2020-10-26 |
| 1740889260 | Oms Associates Colorado PC | Dentist | 10219 Parkglenn Way Ste 201, Parker, CO 80138-3875 | 2020-10-26 |
| 1386266070 | Blue Sky Oms P.C. | Dentist | 1707 61st Ave Ste 102, Greeley, CO 80634-7997 | 2020-05-15 |
| 1679121404 | James W Makowski Dds PC | Dentist | 1220 S Parker Rd Ste 104, Denver, CO 80231-2166 | 2019-08-26 |
| 1528553070 | Comfort Dental Oral Surgery Colorado Springs LLC | Dentist | 556 W. Hwy 105, Monument, CO 80132 | 2018-06-27 |
| 1689167280 | Cheyenne Mountain Oral Surgery PC | Dentist | 640 Southpointe Ct Ste 150, Colorado Springs, CO 80906-3884 | 2018-06-08 |
| 1932692589 | Glendale Oral Surgery PC | Dentist | 3955 E Exposition Ave Ste 520, Denver, CO 80209-5030 | 2018-06-08 |
| 1790292431 | Alix Greenman | Dentist | 6179 S Balsam Way Ste 100, Littleton, CO 80123-3092 | 2018-01-03 |
| 1467964858 | David Andrew Benson, Dds, Pllc | Dentist | 6160 Tutt Blvd Ste 250, Colorado Springs, CO 80923-1500 | 2017-10-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.