Provider Demographics
NPI:1174185581
Name:RUSPINI, DUSTIN (DDS)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:RUSPINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 FOSSIL TRACE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6149
Mailing Address - Country:US
Mailing Address - Phone:970-768-3453
Mailing Address - Fax:
Practice Address - Street 1:2007 JACKSON ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2373
Practice Address - Country:US
Practice Address - Phone:303-279-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204080122300000X
CO00204080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist