Healthcare Provider Details

I. General information

NPI: 1801287040
Provider Name (Legal Business Name): JOAN ESKENS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6162 S.WILLOW DR. STE. 100
GREENWOOD VILLAGE CO
80111
US

IV. Provider business mailing address

6162 S.WILLOW DR. STE. 100
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 303-220-9200
  • Fax: 303-741-4173
Mailing address:
  • Phone: 303-220-9200
  • Fax: 303-741-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number904066
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: