Provider Demographics
NPI:1144322793
Name:SANCHEZ, PORFIRIO BEN (DDS)
Entity type:Individual
Prefix:DR
First Name:PORFIRIO
Middle Name:BEN
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 S FEDERAL BLVD
Mailing Address - Street 2:STE 165
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5473
Mailing Address - Country:US
Mailing Address - Phone:303-934-0232
Mailing Address - Fax:303-934-2208
Practice Address - Street 1:1601 S FEDERAL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4872
Practice Address - Country:US
Practice Address - Phone:303-934-0232
Practice Address - Fax:303-934-2208
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02063337Medicaid