Provider Demographics
NPI:1649575127
Name:BELLEVIEW AND SIMMS DENTAL PROF LLC
Entity Type:Organization
Organization Name:BELLEVIEW AND SIMMS DENTAL PROF LLC
Other - Org Name:COMFORT DENTAL BELLEVIEW AND SIMMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDOIANIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-972-8700
Mailing Address - Street 1:11625 W BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127
Mailing Address - Country:US
Mailing Address - Phone:303-972-8700
Mailing Address - Fax:
Practice Address - Street 1:11625 W BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127
Practice Address - Country:US
Practice Address - Phone:303-972-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10276261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental