Healthcare Provider Details

I. General information

NPI: 1265890768
Provider Name (Legal Business Name): MARYHEN YOHISKA ARRIETA D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2436 S ACADEMY BLVD
COLORADO SPRINGS CO
80916-2408
US

IV. Provider business mailing address

4758 MID RIVERS MALL DR
SAINT PETERS MO
63376-2883
US

V. Phone/Fax

Practice location:
  • Phone: 719-391-2336
  • Fax: 719-391-1625
Mailing address:
  • Phone: 636-266-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026002233
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00202733
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: