Healthcare Provider Details

I. General information

NPI: 1376757799
Provider Name (Legal Business Name): RENEE Y HALL RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 STOUT ST
DENVER CO
80205-2827
US

IV. Provider business mailing address

6214 E 122ND AVE
BRIGHTON CO
80602-9691
US

V. Phone/Fax

Practice location:
  • Phone: 303-312-9679
  • Fax:
Mailing address:
  • Phone: 303-596-7634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2675
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: