1659170454 NPI number — FOX CREEK FAMILY DENTAL WESTMINSTER

Table of content: DR. CHRISTIAN AUGUST ENGELL MD (NPI 1831374305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659170454 NPI number — FOX CREEK FAMILY DENTAL WESTMINSTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOX CREEK FAMILY DENTAL WESTMINSTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659170454
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7995 E PRENTICE AVE STE 211
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-2713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-331-8371
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6415 W 104TH AVE UNIT 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80020-4118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-961-7842
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2025

Additional Information

Authorized Official

Authorized Official Last Name:
GARDUNO
Authorized Official First Name:
KRYSTEN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF REVENUE CYCLE MANAGEMEN
Authorized Official Telephone Number:
307-331-8371

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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