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NPI Code Detail

MEDICARE: SERENE DENTAL HYGIENE

MEDICARE: SERENE DENTAL HYGIENE
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
1305S00000XPoint of ServiceDH000902947CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982074142
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERENE DENTAL HYGIENE
Provider Business Mailing Address
First Line : 8120 ENGLETON CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-6150
Country : US
Telephone Number : 719-290-9804
Fax Number :
Provider Business Practice Location Address
First Line : 7770 N UNION BLVD
Second Line : SUITE A
City : COLORADO SPRINGS
State : CO
Zip : 80920-4087
Country : US
Telephone Number : 719-290-9804
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. LORI JO KINZER
Credential : RDH
Telephone Number : 719-290-9804
Provider Enumeration Date : 09/30/2015
Last Update Date : 09/30/2015

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Practice Location Address:
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1811940067 — DR. KATHARINE JULIA LEPPARD M.D.
Practice Location Address:
3470 CENTENNIAL BLVD , SUITE 110
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Practice Fax: 719-575-1850

Directions to “SERENE DENTAL HYGIENE ” Practice Location

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