Healthcare Provider Details

I. General information

NPI: 1427934512
Provider Name (Legal Business Name): LOTUS DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7479 E 29TH PL
DENVER CO
80238-2704
US

IV. Provider business mailing address

7479 E 29TH PL
DENVER CO
80238-2704
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-4445
  • Fax:
Mailing address:
  • Phone: 303-321-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. DOLAVA TEERDHA PATI
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 802-734-8550