Provider Demographics
NPI:1336574615
Name:DAY DREAM DENTAL CARE
Entity Type:Organization
Organization Name:DAY DREAM DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEISENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-332-7725
Mailing Address - Street 1:7820 INVERNESS BLVD E UNIT 203
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5713
Mailing Address - Country:US
Mailing Address - Phone:720-469-8113
Mailing Address - Fax:
Practice Address - Street 1:7820 INVERNESS BLVD E UNIT 203
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5713
Practice Address - Country:US
Practice Address - Phone:720-469-8113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1048151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23627OtherDHA
CO141676OtherCIGNA DH
CO1B0J7VOtherBCBS
CO02048155Medicaid
CO0010014OtherFORTIS
CO573669OtherUNITED CONCORDIA