Provider Demographics
NPI:1932326097
Name:MICHAEL, DEBORAH J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:J
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20981 E SMOKY HILL RD STE F
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5189
Mailing Address - Country:US
Mailing Address - Phone:720-876-2000
Mailing Address - Fax:303-690-8012
Practice Address - Street 1:20981 E SMOKY HILL RD STE F
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5189
Practice Address - Country:US
Practice Address - Phone:720-876-2000
Practice Address - Fax:303-690-8012
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO70161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU97905Medicare UPIN