Healthcare Provider Details

I. General information

NPI: 1922504786
Provider Name (Legal Business Name): ALYSSA JILLIAN ESTES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 ALBROOK DR
DENVER CO
80239-4604
US

IV. Provider business mailing address

6787 E EXPOSITION AVE
DENVER CO
80224-1508
US

V. Phone/Fax

Practice location:
  • Phone: 561-703-7246
  • Fax:
Mailing address:
  • Phone: 561-703-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT0472
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0074324
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: