Provider Demographics
NPI:1801866207
Name:SMITH, DANA J (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:300 CENTER DR
Mailing Address - Street 2:STE G #111
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8633
Mailing Address - Country:US
Mailing Address - Phone:206-202-1035
Mailing Address - Fax:206-202-1035
Practice Address - Street 1:300 CENTER DR
Practice Address - Street 2:STE G #111
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8633
Practice Address - Country:US
Practice Address - Phone:206-202-1035
Practice Address - Fax:206-202-1035
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2009-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO25338207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27987540Medicaid
CO27987540Medicaid
D94320Medicare UPIN