Healthcare Provider Details

I. General information

NPI: 1154215127
Provider Name (Legal Business Name): RUTVIJ PADHIAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 E ALLEN ST STE 1000
CASTLE ROCK CO
80108-7823
US

IV. Provider business mailing address

6200 CASTLEGATE DR W
CASTLE ROCK CO
80108-8616
US

V. Phone/Fax

Practice location:
  • Phone: 303-660-6883
  • Fax:
Mailing address:
  • Phone: 813-550-3776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206727
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: