Provider Demographics
NPI:1154447084
Name:KRANNAWITTER, JEFF L (DDS)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:L
Last Name:KRANNAWITTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9939 NEWTON CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2649
Mailing Address - Country:US
Mailing Address - Phone:303-243-4661
Mailing Address - Fax:
Practice Address - Street 1:8721 WADSWORTH BLVD STE B
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-0920
Practice Address - Country:US
Practice Address - Phone:303-420-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice