Healthcare Provider Details

I. General information

NPI: 1396684023
Provider Name (Legal Business Name): STEFFI GINNY BRYANT RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5245 CENTENNIAL BLVD STE 207
COLORADO SPRINGS CO
80919-4405
US

IV. Provider business mailing address

5245 CENTENNIAL BLVD STE 207
COLORADO SPRINGS CO
80919-4405
US

V. Phone/Fax

Practice location:
  • Phone: 719-402-3232
  • Fax: 719-402-3232
Mailing address:
  • Phone: 719-402-3232
  • Fax: 719-402-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH.002026172
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: