Healthcare Provider Details

I. General information

NPI: 1558275503
Provider Name (Legal Business Name): JENNIFER DOELL CRDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S ASPEN ST
AURORA CO
80011-9562
US

IV. Provider business mailing address

275 S ASPEN ST
AURORA CO
80011-9562
US

V. Phone/Fax

Practice location:
  • Phone: 720-847-4118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number002027783
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number35886
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: