Provider Demographics
NPI:1093882870
Name:SIERK, JONATHAN DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DAVID
Last Name:SIERK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6660 TIMBERLINE RD
Mailing Address - Street 2:SUITE #240
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130
Mailing Address - Country:US
Mailing Address - Phone:303-865-4066
Mailing Address - Fax:303-865-4067
Practice Address - Street 1:6660 TIMBERLINE RD
Practice Address - Street 2:SUITE #240
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130
Practice Address - Country:US
Practice Address - Phone:303-865-4066
Practice Address - Fax:303-865-4067
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86701223P0221X
IA080451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry