Healthcare Provider Details

I. General information

NPI: 1508798422
Provider Name (Legal Business Name): MATIN SANAEI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18680 E ILIFF AVE UNIT AB
AURORA CO
80013-6540
US

IV. Provider business mailing address

18680 E ILIFF AVE UNIT AB
AURORA CO
80013-6540
US

V. Phone/Fax

Practice location:
  • Phone: 303-751-5010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206704
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: