Healthcare Provider Details

I. General information

NPI: 1669116646
Provider Name (Legal Business Name): AYRTON JEFFREY SANGUINO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 BANNOCK ST STE 7770
DENVER CO
80204-4506
US

IV. Provider business mailing address

660 BANNOCK ST STE 7770
DENVER CO
80204-4506
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-8744
  • Fax:
Mailing address:
  • Phone: 303-602-8744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00206026
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.033570
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDEN.00206026
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: