Provider Demographics
NPI:1174573414
Name:WARTA, BENJAMIN THOMAS (OD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:THOMAS
Last Name:WARTA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10141 ASTORBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7834
Mailing Address - Country:US
Mailing Address - Phone:720-344-8230
Mailing Address - Fax:
Practice Address - Street 1:2766 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3408
Practice Address - Country:US
Practice Address - Phone:303-935-2020
Practice Address - Fax:303-935-4989
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MW1043924OtherDEA
MW1043924OtherDEA
U90097Medicare UPIN