Provider Demographics
NPI:1275181976
Name:DENNIS KOTELKO MD INC
Entity Type:Organization
Organization Name:DENNIS KOTELKO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTELKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-726-1413
Mailing Address - Street 1:8400 E PRENTICE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2952
Mailing Address - Country:US
Mailing Address - Phone:720-480-9500
Mailing Address - Fax:
Practice Address - Street 1:8400 E PRENTICE AVE STE 800
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2952
Practice Address - Country:US
Practice Address - Phone:720-480-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty