Healthcare Provider Details

I. General information

NPI: 1255262002
Provider Name (Legal Business Name): RAYMOND JOSEPH HATZENBELLER III DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 ATRIUM DR UNIT 130
CASTLE ROCK CO
80108-1927
US

IV. Provider business mailing address

5715 ATRIUM DR UNIT 130
CASTLE ROCK CO
80108-1927
US

V. Phone/Fax

Practice location:
  • Phone: 720-805-2425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206633
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: