Provider Demographics
NPI:1891082491
Name:BANGIYEV, JOHN NIKOLAY (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NIKOLAY
Last Name:BANGIYEV
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5504
Mailing Address - Country:US
Mailing Address - Phone:303-301-9019
Mailing Address - Fax:
Practice Address - Street 1:2055 N HIGH ST STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5504
Practice Address - Country:US
Practice Address - Phone:303-301-9019
Practice Address - Fax:303-861-6254
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019122207YS0123X
CO58725207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Single Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty