Healthcare Provider Details

I. General information

NPI: 1609706282
Provider Name (Legal Business Name): ALVARO EMILIO BALLADARES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 W COAL MINE AVE STE 106
LITTLETON CO
80123-4400
US

IV. Provider business mailing address

8583 CHERAW ST
LITTLETON CO
80125-8510
US

V. Phone/Fax

Practice location:
  • Phone: 303-569-8177
  • Fax:
Mailing address:
  • Phone: 305-609-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN00206676
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: