Healthcare Provider Details

I. General information

NPI: 1922936889
Provider Name (Legal Business Name): LUMINOUS DENTAL STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8355 E 32ND AVE APT 238
DENVER CO
80238-4430
US

IV. Provider business mailing address

8355 E 32ND AVE APT 238
DENVER CO
80238-4430
US

V. Phone/Fax

Practice location:
  • Phone: 720-477-0282
  • Fax:
Mailing address:
  • Phone: 720-477-0282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS AILEEN ATZIRY MORELOS
Title or Position: REGISTERED DENTAL HYGIENIST
Credential: RDH
Phone: 951-801-9829