Healthcare Provider Details

I. General information

NPI: 1679623243
Provider Name (Legal Business Name): INNA E DUNKER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INNA A ERMOLAEVA DDS

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 S ONEIDA ST S-321
DENVER CO
80224-2549
US

IV. Provider business mailing address

2121 S ONEIDA ST S-321
DENVER CO
80224-2549
US

V. Phone/Fax

Practice location:
  • Phone: 303-796-8767
  • Fax: 303-694-6238
Mailing address:
  • Phone: 303-796-8767
  • Fax: 303-694-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7337
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: