Healthcare Provider Details

I. General information

NPI: 1629769500
Provider Name (Legal Business Name): EMILY ANN JOY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6632 W 10TH ST STE 101
GREELEY CO
80634-9734
US

IV. Provider business mailing address

6632 W 10TH ST STE 101
GREELEY CO
80634-9734
US

V. Phone/Fax

Practice location:
  • Phone: 970-353-4848
  • Fax:
Mailing address:
  • Phone: 970-353-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206724
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: