Healthcare Provider Details

I. General information

NPI: 1922636604
Provider Name (Legal Business Name): SHALINI SACHDEVA JAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 48TH ST
BOULDER CO
80301-2711
US

IV. Provider business mailing address

5582 W 96TH AVE
WESTMINSTER CO
80020-5693
US

V. Phone/Fax

Practice location:
  • Phone: 303-604-5000
  • Fax:
Mailing address:
  • Phone: 303-903-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0077321
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: