Provider Demographics
NPI:1902614407
Name:SUGAR BUGS PEDIATRIC DENTISTRY PLLC
Entity type:Organization
Organization Name:SUGAR BUGS PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANDI
Authorized Official - Middle Name:VENA
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-427-9779
Mailing Address - Street 1:7578 SHERIDAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-6214
Mailing Address - Country:US
Mailing Address - Phone:303-427-9779
Mailing Address - Fax:
Practice Address - Street 1:7578 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-6214
Practice Address - Country:US
Practice Address - Phone:303-427-9779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty