Provider Demographics
NPI:1790879807
Name:WINBER, STEPHEN MYRON (DDS, MPS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MYRON
Last Name:WINBER
Suffix:
Gender:M
Credentials:DDS, MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 S ALBION ST
Mailing Address - Street 2:1008
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4008
Mailing Address - Country:US
Mailing Address - Phone:303-691-0267
Mailing Address - Fax:303-691-0268
Practice Address - Street 1:1660 S ALBION ST
Practice Address - Street 2:1008
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4008
Practice Address - Country:US
Practice Address - Phone:303-691-0267
Practice Address - Fax:303-691-0268
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02026383Medicaid
COU47947Medicare UPIN