Healthcare Provider Details

I. General information

NPI: 1790608362
Provider Name (Legal Business Name): AIDAN OERTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N GRANT ST STE R
DENVER CO
80203-1859
US

IV. Provider business mailing address

2526 N CLAY ST APT 9
DENVER CO
80211-4742
US

V. Phone/Fax

Practice location:
  • Phone: 402-580-0463
  • Fax:
Mailing address:
  • Phone: 402-580-0463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: