Provider Demographics
NPI:1205053881
Name:AJDARI, JURAK (DDS)
Entity type:Individual
Prefix:DR
First Name:JURAK
Middle Name:
Last Name:AJDARI
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 1:9025 E MINERAL CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3468
Mailing Address - Country:US
Mailing Address - Phone:303-471-4300
Mailing Address - Fax:
Practice Address - Street 1:9025 E MINERAL CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3468
Practice Address - Country:US
Practice Address - Phone:303-471-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90811223G0001X
CA554701223G0001X
MI29010186611223G0001X
HI22051223G0001X
NY0526021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice