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Provider Information for 1851716492

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1851716492

Calendar   Last Updated:  2017-12-07
  Certification Date: 


Name Value
NPI 1851716492
Enumeration Date 2014-02-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1300 S WILLOW ST APT 2101
DENVER, CO 80247-2125
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 14251 E 6TH AVE
AURORA, CO 80011-8706
United States

Phone: 303-343-3133 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CO 202149