Provider Demographics
NPI:1700363579
Name:RONALD E. UNTERSEHER, DDS, MS
Entity type:Organization
Organization Name:RONALD E. UNTERSEHER, DDS, MS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:UNTERSEHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-466-1955
Mailing Address - Street 1:10359 FEDERAL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-7453
Mailing Address - Country:US
Mailing Address - Phone:303-466-1955
Mailing Address - Fax:303-466-8100
Practice Address - Street 1:155 COOK ST STE 451
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5330
Practice Address - Country:US
Practice Address - Phone:303-466-1955
Practice Address - Fax:303-466-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1049081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1881732376Medicaid