Provider Demographics
NPI:1942248752
Name:WINNICKI, JEFFREY LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LAWRENCE
Last Name:WINNICKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 W 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5019
Mailing Address - Country:US
Mailing Address - Phone:303-596-2913
Mailing Address - Fax:303-665-8293
Practice Address - Street 1:297 US HIGHWAY 287
Practice Address - Street 2:SUITE 104
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8932
Practice Address - Country:US
Practice Address - Phone:303-665-8321
Practice Address - Fax:303-665-8293
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO88391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice