Provider Demographics
NPI:1821446436
Name:DATAR, JOSEPH NIKKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NIKKI
Last Name:DATAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3417
Mailing Address - Country:US
Mailing Address - Phone:719-502-1888
Mailing Address - Fax:303-694-6270
Practice Address - Street 1:7447 E BERRY AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2146
Practice Address - Country:US
Practice Address - Phone:303-741-3300
Practice Address - Fax:303-694-6270
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002027651223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics