Healthcare Provider Details

I. General information

NPI: 1851237655
Provider Name (Legal Business Name): IST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 TEJON ST
DENVER CO
80211-2215
US

IV. Provider business mailing address

1572 OSCEOLA ST
DENVER CO
80204-1456
US

V. Phone/Fax

Practice location:
  • Phone: 720-722-0180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ISHITA TOPIWALA
Title or Position: MANAGER
Credential: DDS
Phone: 720-722-0180