Provider Demographics
NPI:1134106909
Name:GRIFFIN, DENNIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 E GEDDES AVE
Mailing Address - Street 2:NO 200
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3800
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:303-761-6278
Practice Address - Street 1:501 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:303-761-6278
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261082085R0202X
NE250342085R0202X
KS04-220192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025709000Medicaid
SD1134106909/7726680Medicaid
KS200254550AOtherKS MEDICAID
NEP00720353OtherRRMCR NE
CAXPY201226OtherCA MEDICAID
CO01261080Medicaid
NE84-059792913Medicaid
MI104686178OtherMI MEDICAID
UT1134106909Medicaid
TX053219401OtherTX MEDICAID
OK200025490AOtherOK MEDICAID
CO300048001OtherRR MCRE RIA
AZ864805Medicaid
CO300090003OtherRR MCRE DIA
NY02558496OtherNY MEDICAID
MT1134106909OtherMT MEDICAID
WY1134106909Medicaid
CO300090004OtherRR MCRE MIC
NM15583783OtherNM MEDICAID
OK200025490AOtherOK MEDICAID
COE23272Medicare UPIN
SD1134106909/7726680Medicaid
COC211708Medicare PIN
NENA1215017Medicare PIN
COC22164Medicare PIN
NENA2517022Medicare PIN
TX053219401OtherTX MEDICAID
NE10025709000Medicaid
UT1134106909Medicaid
KS111257015Medicare PIN