Healthcare Provider Details

I. General information

NPI: 1770075467
Provider Name (Legal Business Name): DRY CREEK SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9051 SSG CHRIS FALKEL DR UNIT 400
HIGHLANDS RANCH CO
80129-3198
US

IV. Provider business mailing address

9051 SSG CHRIS FALKEL DR UNIT 400
HIGHLANDS RANCH CO
80129-3198
US

V. Phone/Fax

Practice location:
  • Phone: 844-691-3740
  • Fax: 833-554-7009
Mailing address:
  • Phone: 844-691-3740
  • Fax: 833-554-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENA HUMER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 303-792-0777