Provider Demographics
NPI:1609019066
Name:JASON L HEIKEN, DDS, PC
Entity Type:Organization
Organization Name:JASON L HEIKEN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:HEIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-781-3603
Mailing Address - Street 1:10111 INVERNESS MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5722
Mailing Address - Country:US
Mailing Address - Phone:303-781-3603
Mailing Address - Fax:303-781-3703
Practice Address - Street 1:10111 INVERNESS MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5722
Practice Address - Country:US
Practice Address - Phone:303-781-3603
Practice Address - Fax:303-781-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7220122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1750377321OtherPERSONAL NPI #