Provider Demographics
NPI:1003911504
Name:LAMPERT, JODI (DDS, PC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:LAMPERT
Suffix:
Gender:F
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8120 S HOLLY ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-4005
Mailing Address - Country:US
Mailing Address - Phone:303-779-8848
Mailing Address - Fax:
Practice Address - Street 1:8120 S HOLLY ST
Practice Address - Street 2:SUITE 116
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4005
Practice Address - Country:US
Practice Address - Phone:303-779-8848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist