Healthcare Provider Details

I. General information

NPI: 1598676413
Provider Name (Legal Business Name): AVA SANBORN RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10260 E COLFAX AVE
AURORA CO
80010-5017
US

IV. Provider business mailing address

460 FLATIRON BLVD UNIT 1032
BROOMFIELD CO
80021-8391
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-7433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH.002027655
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: