Healthcare Provider Details

I. General information

NPI: 1306551387
Provider Name (Legal Business Name): ELENA CIOBANU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 S MOBILE PL
AURORA CO
80017-3148
US

IV. Provider business mailing address

13065 E 17TH AVE
AURORA CO
80045-2532
US

V. Phone/Fax

Practice location:
  • Phone: 802-343-5481
  • Fax:
Mailing address:
  • Phone: 303-724-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00205446
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: