Healthcare Provider Details

I. General information

NPI: 1104401223
Provider Name (Legal Business Name): NADEGE EILERMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 5TH ST STE 300
CASTLE ROCK CO
80104
US

IV. Provider business mailing address

610 5TH ST STE 300
CASTLE ROCK CO
80104
US

V. Phone/Fax

Practice location:
  • Phone: 303-633-4633
  • Fax:
Mailing address:
  • Phone: 303-633-4633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00206178
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: