Healthcare Provider Details
I. General information
NPI: 1659086023
Provider Name (Legal Business Name): KINDA PLLC-DBA CHERRY CREEK PEDIATRIC DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2023
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5055 E KENTUCKY AVE STE A
DENVER CO
80246-2279
US
IV. Provider business mailing address
5055 E KENTUCKY AVE STE A
DENVER CO
80246-2279
US
V. Phone/Fax
- Phone: 303-757-8844
- Fax: 303-759-0994
- Phone: 303-757-8844
- Fax: 303-759-0994
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KOJO
GYIMAH
DANSO
Title or Position: PEDIATRIC DENTIST
Credential: DMD
Phone: 520-991-7605