Healthcare Provider Details

I. General information

NPI: 1326921024
Provider Name (Legal Business Name): ANSU ANN ABRAHAM DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6375 LEHMAN DR STE 200
COLORADO SPRINGS CO
80918-1427
US

IV. Provider business mailing address

6001 SW 12TH ST APT 1111
OKLAHOMA CITY OK
73128-1872
US

V. Phone/Fax

Practice location:
  • Phone: 719-593-9182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00206607
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: