Provider Demographics
NPI:1154681575
Name:COX, JEREMY S (DMD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:S
Last Name:COX
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 1:570 CHAPARRAL DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-9533
Mailing Address - Country:US
Mailing Address - Phone:970-639-9551
Mailing Address - Fax:
Practice Address - Street 1:2466 HWY 6 AND 50 STE 3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-5500
Practice Address - Country:US
Practice Address - Phone:970-639-9551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry