Provider Demographics
NPI:1346544350
Name:WYNKOOP DENTAL, PLLC
Entity Type:Organization
Organization Name:WYNKOOP DENTAL, PLLC
Other - Org Name:WYNKOOP DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-572-4487
Mailing Address - Street 1:1501 WAZEE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1476
Mailing Address - Country:US
Mailing Address - Phone:303-572-4487
Mailing Address - Fax:303-623-3346
Practice Address - Street 1:1501 WAZEE ST STE 1A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1476
Practice Address - Country:US
Practice Address - Phone:720-425-8230
Practice Address - Fax:303-317-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty