1952847485 NPI number — AURARIA DENTAL OASIS

Table of content: (NPI 1952847485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952847485 NPI number — AURARIA DENTAL OASIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AURARIA DENTAL OASIS
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:
6
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:
1952847485
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1050 W COLFAX AVE
Provider Second Line Business Mailing Address:
SUITE G
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80204-2072
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-573-5533
Provider Business Mailing Address Fax Number:
303-573-5539

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 W COLFAX AVE
Provider Second Line Business Practice Location Address:
SUITE G
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-2072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-573-5533
Provider Business Practice Location Address Fax Number:
303-573-5539
Provider Enumeration Date:
01/08/2017

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
KENDALL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-573-5533

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DEN.00104752 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com