Provider Demographics
NPI:1013131093
Name:ACEVEDO, ALEXANDER PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:PETER
Last Name:ACEVEDO
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 1:13533 HURON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-1158
Mailing Address - Country:US
Mailing Address - Phone:303-452-3982
Mailing Address - Fax:303-452-2949
Practice Address - Street 1:13533 HURON ST STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-1158
Practice Address - Country:US
Practice Address - Phone:303-452-3982
Practice Address - Fax:303-452-2949
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.001053221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice