Healthcare Provider Details

I. General information

NPI: 1336008853
Provider Name (Legal Business Name): RIVER VALLEY DENTAL HYGIENE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 N UNION BLVD STE 104
COLORADO SPRINGS CO
80918-2057
US

IV. Provider business mailing address

5170 N UNION BLVD STE 104
COLORADO SPRINGS CO
80918-2057
US

V. Phone/Fax

Practice location:
  • Phone: 719-470-0745
  • Fax:
Mailing address:
  • Phone: 719-470-0745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: LENNON TOTTEN
Title or Position: RDH
Credential: RDH
Phone: 719-470-0745