Healthcare Provider Details

I. General information

NPI: 1043157480
Provider Name (Legal Business Name): LOTUS DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S FRASER ST UNIT 3
AURORA CO
80014-4515
US

IV. Provider business mailing address

2222 S FRASER ST UNIT 3
AURORA CO
80014-4515
US

V. Phone/Fax

Practice location:
  • Phone: 303-671-0305
  • Fax: 303-369-6627
Mailing address:
  • Phone: 303-671-0305
  • Fax: 303-369-6627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOLAVA TEERDHA PATI
Title or Position: OWNER
Credential: DDS
Phone: 802-734-8550