Provider Demographics
NPI:1376567396
Name:DEAN, JOEL M (DO)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:M
Last Name:DEAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:744 HORIZON CT STE 360
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-3936
Mailing Address - Country:US
Mailing Address - Phone:970-243-8328
Mailing Address - Fax:970-245-7240
Practice Address - Street 1:744 HORIZON CT
Practice Address - Street 2:STE 360
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-3921
Practice Address - Country:US
Practice Address - Phone:970-243-8328
Practice Address - Fax:970-245-7240
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO286472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01286475Medicaid
A10686Medicare UPIN
C3222Medicare PIN