Provider Demographics
NPI:1922783638
Name:DR ASHRAF W SEDHOM BDS MD PC
Entity Type:Organization
Organization Name:DR ASHRAF W SEDHOM BDS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDHOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-344-0810
Mailing Address - Street 1:7373 W JEFFERSON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2020
Mailing Address - Country:US
Mailing Address - Phone:303-344-0810
Mailing Address - Fax:
Practice Address - Street 1:7373 W JEFFERSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2020
Practice Address - Country:US
Practice Address - Phone:303-344-0810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR ASHRAF W SEDHOM BDS MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty