Healthcare Provider Details

I. General information

NPI: 1689519712
Provider Name (Legal Business Name): NINA IMSIRPASIC RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10680 DEL MAR PKWY
AURORA CO
80010-4011
US

IV. Provider business mailing address

20576 E LAKE DR
AURORA CO
80016-3886
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-7433
  • Fax:
Mailing address:
  • Phone: 303-762-6559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberLOCAL.2777643
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH.000905557
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: