Provider Demographics
NPI:1699848333
Name:DEREK A. STRAFFON, DDS, MS, PC
Entity Type:Organization
Organization Name:DEREK A. STRAFFON, DDS, MS, PC
Other - Org Name:303 SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:ATWOOD
Authorized Official - Last Name:STRAFFON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-758-3414
Mailing Address - Street 1:8745 E ORCHARD RD STE 513
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5007
Mailing Address - Country:US
Mailing Address - Phone:303-758-3414
Mailing Address - Fax:
Practice Address - Street 1:8745 E ORCHARD RD STE 513
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5007
Practice Address - Country:US
Practice Address - Phone:303-758-3414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty