Healthcare Provider Details

I. General information

NPI: 1952310518
Provider Name (Legal Business Name): NELSON S. JOO, D.M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S FRASER ST UNIT 3
AURORA CO
80014-4515
US

IV. Provider business mailing address

2222 S FRASER ST UNIT 3
AURORA CO
80014-4515
US

V. Phone/Fax

Practice location:
  • Phone: 303-671-0305
  • Fax:
Mailing address:
  • Phone: 303-671-0305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: VONDA ELKINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 303-671-0305