Provider Demographics
NPI:1649663014
Name:EVERYONE DENTAL
Entity type:Organization
Organization Name:EVERYONE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-307-9999
Mailing Address - Street 1:3471 N SALIDA CT
Mailing Address - Street 2:AUIE 40
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5020
Mailing Address - Country:US
Mailing Address - Phone:303-307-9999
Mailing Address - Fax:303-307-9992
Practice Address - Street 1:3464 N. SALIDA ST
Practice Address - Street 2:UNIT B
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-5020
Practice Address - Country:US
Practice Address - Phone:303-307-9999
Practice Address - Fax:303-307-9992
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A2K
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60023333Medicaid