Provider Demographics
NPI:1891919452
Name:SUMNER, JILL L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:L
Last Name:SUMNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2993 S. PEORIA ST.
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:303-322-1964
Mailing Address - Fax:
Practice Address - Street 1:2993 S PEORIA ST
Practice Address - Street 2:STE. 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3107
Practice Address - Country:US
Practice Address - Phone:303-696-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9085122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice