Provider Demographics
NPI:1891798690
Name:DR. THOMAS MATSUI, D.D.S., P.C.
Entity Type:Organization
Organization Name:DR. THOMAS MATSUI, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:MATSUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-234-0505
Mailing Address - Street 1:1526 COLE BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3410
Mailing Address - Country:US
Mailing Address - Phone:303-234-0505
Mailing Address - Fax:303-234-0226
Practice Address - Street 1:1526 COLE BLVD
Practice Address - Street 2:STE 120
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3410
Practice Address - Country:US
Practice Address - Phone:303-234-0505
Practice Address - Fax:303-234-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1050421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty