Healthcare Provider Details

I. General information

NPI: 1093628620
Provider Name (Legal Business Name): ADENA LEI DUNCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3222 HIGHWAY 6&24
CLIFTON CO
81520
US

IV. Provider business mailing address

135 WINTERLAND CT
FRUITA CO
81521-8324
US

V. Phone/Fax

Practice location:
  • Phone: 970-438-0076
  • Fax:
Mailing address:
  • Phone: 970-644-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH.002024702
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: