Healthcare Provider Details

I. General information

NPI: 1063640761
Provider Name (Legal Business Name): CARA JOY RILEY DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE # B240
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE # B240
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6788
  • Fax:
Mailing address:
  • Phone: 720-777-3488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number10727
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number9366
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberDEN.00010727
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: