Healthcare Provider Details

I. General information

NPI: 1538376124
Provider Name (Legal Business Name): HILARY NIEBERG BASKIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S MONACO PARKWAY
DENVER CO
80222
US

IV. Provider business mailing address

5865 E POWERS AVE
GREENWOOD VILLAGE CO
80111-1545
US

V. Phone/Fax

Practice location:
  • Phone: 303-476-6233
  • Fax:
Mailing address:
  • Phone: 303-907-7978
  • Fax: 303-341-5447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6889
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: