Provider Demographics
NPI:1033468269
Name:LOBERG, JEFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:LOBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 BENTON ST UNIT 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3027
Mailing Address - Country:US
Mailing Address - Phone:303-422-6464
Mailing Address - Fax:303-432-0608
Practice Address - Street 1:9111 BENTON ST UNIT 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3027
Practice Address - Country:US
Practice Address - Phone:303-422-6464
Practice Address - Fax:303-432-0608
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190291511223E0200X, 1223G0001X
MS4250-211223E0200X
CODEN.002058931223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice