Provider Demographics
NPI:1871849802
Name:PODARU, ALEX (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:PODARU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:FLORIN-ALEXANDRU
Other - Middle Name:
Other - Last Name:PODARU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6116 VACQUERO DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9160
Mailing Address - Country:US
Mailing Address - Phone:352-231-2970
Mailing Address - Fax:
Practice Address - Street 1:6116 VACQUERO DR
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-9160
Practice Address - Country:US
Practice Address - Phone:352-231-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002061951223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR1063OtherDR ID NUMBER