Provider Demographics
NPI:1477641314
Name:PINKNER, JAY CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:CRAIG
Last Name:PINKNER
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 1:1361 FRANCIS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-2576
Mailing Address - Country:US
Mailing Address - Phone:303-776-0117
Mailing Address - Fax:720-494-9286
Practice Address - Street 1:1361 FRANCIS ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2576
Practice Address - Country:US
Practice Address - Phone:303-776-0117
Practice Address - Fax:720-494-9286
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8268122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist