Provider Demographics
NPI:1750778270
Name:DENTAL HYGIENE WELLNESS CLINIC
Entity type:Organization
Organization Name:DENTAL HYGIENE WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:
Authorized Official - First Name:JANKEE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:720-456-9050
Mailing Address - Street 1:2905 INCA ST
Mailing Address - Street 2:2047
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1023
Mailing Address - Country:US
Mailing Address - Phone:720-456-9050
Mailing Address - Fax:
Practice Address - Street 1:2905 INCA ST
Practice Address - Street 2:2047
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1023
Practice Address - Country:US
Practice Address - Phone:720-456-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH 000906510124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty