Provider Demographics
NPI:1023737186
Name:DR. SIONA MOTUFAU JR. DDS CO
Entity type:Organization
Organization Name:DR. SIONA MOTUFAU JR. DDS CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTUFAU
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-712-1463
Mailing Address - Street 1:3222 HWY 6 AND 24
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520
Mailing Address - Country:US
Mailing Address - Phone:970-985-7200
Mailing Address - Fax:
Practice Address - Street 1:3222 HIGHWAY 6 AND 24
Practice Address - Street 2:
Practice Address - City:CLIFTION
Practice Address - State:CO
Practice Address - Zip Code:81520
Practice Address - Country:US
Practice Address - Phone:970-985-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO202301Medicaid