Provider Demographics
NPI:1114350402
Name:DENVER SOUTH DENTAL PARTNERS PLLC
Entity Type:Organization
Organization Name:DENVER SOUTH DENTAL PARTNERS PLLC
Other - Org Name:DENVER SOUTH DENTAL PARTNERS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-489-0298
Mailing Address - Street 1:3030 NORTH CENTRAL AVENUE, SUITE 1500
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012
Mailing Address - Country:US
Mailing Address - Phone:480-339-4800
Mailing Address - Fax:480-339-4812
Practice Address - Street 1:2731 WEST EVANS AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219
Practice Address - Country:US
Practice Address - Phone:720-636-9828
Practice Address - Fax:480-339-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD8182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty