Healthcare Provider Details

I. General information

NPI: 1942707682
Provider Name (Legal Business Name): KIMBERLY ALLIN MEYERS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 N. BANNOCK ST. PAVILION L, FLOOR 7
DENVER CO
80204-4507
US

IV. Provider business mailing address

660 BANNOCK ST FL 7
DENVER CO
80204-4506
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00205100
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10380
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: