Healthcare Provider Details

I. General information

NPI: 1265364186
Provider Name (Legal Business Name): LAJESSIE DINH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

250 E COLFAX AVE
BENNETT CO
80102-8825
US

IV. Provider business mailing address

6696 N NEPAL ST
AURORA CO
80019-2420
US

V. Phone/Fax

Practice location:
  • Phone: 303-558-1048
  • Fax:
Mailing address:
  • Phone: 303-682-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206703
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: