MEDICARE: DR. HANNAH ELLEN LIBBY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DEN.00205191	CO

General Provider Information

NPI Number	:	1730819160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANNAH ELLEN LIBBY DDS

Provider Business Mailing Address
First Line	:	5955 DUBLIN BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7474
Country	:	US
Telephone Number	:	719-596-3481
Fax Number	:

Provider Business Practice Location Address
First Line	:	5955 DUBLIN BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7474
Country	:	US
Telephone Number	:	195-963-4817
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2022
Last Update Date	:	05/29/2025

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