Provider Demographics
NPI:1396940003
Name:REJMAN, DANIEL JOHN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:REJMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 18-A
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5728
Mailing Address - Country:US
Mailing Address - Phone:303-462-1462
Mailing Address - Fax:303-997-5646
Practice Address - Street 1:15159 E COLFAX AVE UNIT B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-5707
Practice Address - Country:US
Practice Address - Phone:303-341-5437
Practice Address - Fax:303-341-6447
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO92571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO25939335Medicaid