Provider Demographics
NPI:1750559985
Name:LIA D. BAROS D.D.S., P.C.
Entity type:Organization
Organization Name:LIA D. BAROS D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LIA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:BAROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-433-7500
Mailing Address - Street 1:3538 W 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1314
Mailing Address - Country:US
Mailing Address - Phone:303-433-7500
Mailing Address - Fax:
Practice Address - Street 1:3538 W 44TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1314
Practice Address - Country:US
Practice Address - Phone:303-433-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN86571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO52800717Medicaid