Healthcare Provider Details

I. General information

NPI: 1821914532
Provider Name (Legal Business Name): DAN RODDA, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7920 S UNIVERSITY BLVD STE 200
CENTENNIAL CO
80122-5103
US

IV. Provider business mailing address

449 W WULFENITE RD
FLAGSTAFF AZ
86005-6836
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-0797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAN RODDA
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 928-525-4642