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BOULDER ORAL SURGERY
NPI 1467967307
Dentist - Oral and Maxillofacial Surgery in Boulder, CO

Active since December 13, 2017
3450 PENROSE PL STE 120, BOULDER, CO 80301(303) 447-9735(303) 447-9735 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Dec 13, 2017 (2 updates tracked since 2017).

About Boulder Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOULDER ORAL SURGERY (NPI 1467967307) is a healthcare organization registered as an oral and maxillofacial surgery in Boulder, Colorado and active in the NPI registry since December 2017. The organization maintains a secondary practice location in Longmont and lists Terrence Robert Nedbalski, Owner, as its authorized official.

NPPES Registry Identity

NPI1467967307
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameBOULDER ORAL SURGERY
Location Address3450 PENROSE PL STE 120Boulder, CO 80301-1800
Mailing Address3450 Penrose Pl, Suite 120Boulder, CO 80301-1800 · (303) 447-9735 · Fax (303) 447-1025
Phone(303) 447-9735
Fax(303) 447-9735
Organization SubpartYesParent: Terrence Nedbalski Dds Pllc
Authorized OfficialTerrence Robert NedbalskiOwner · (303) 447-9735
Enumeration DateDecember 13, 2017
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1467967307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CO · 9410
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
3450 PENROSE PL STE 120, Boulder, CO 80301
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Other Names 1

Doing Business AsBoulder Oral Surgery

Secondary Practice Location 1

Location 11325 Hover St Ste 101Longmont, CO 80501-3137 · Phone (303) 772-8585 · Fax (303) 776-4895

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES BRANDON MATHIAS LUTER D.D.S.
Oral & Maxillofacial Surgery
3450 PENROSE PL STE 120
BOULDER, CO 80301
Boulder County (303) 447-9735

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boulder Oral Surgery's NPI number?

The NPI number for Boulder Oral Surgery is 1467967307. It was assigned to this organization in the NPPES registry on December 13, 2017.

Where is Boulder Oral Surgery located?

Boulder Oral Surgery is located at 3450 Penrose Pl Ste 120, Boulder, CO 80301. The listed phone number is (303) 447-9735.

What is Boulder Oral Surgery's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Boulder Oral Surgery was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.