Healthcare Provider Details

I. General information

NPI: 1215467501
Provider Name (Legal Business Name): YEVGENIY MONASTYRSKIY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6660 E HAMPDEN AVE STE 201
DENVER CO
80224-3035
US

IV. Provider business mailing address

12474 E TENNESSEE CIR
AURORA CO
80012
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-5599
  • Fax:
Mailing address:
  • Phone: 303-669-6713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00203210
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: