Healthcare Provider Details

I. General information

NPI: 1528977295
Provider Name (Legal Business Name): LUZ RAYMONDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10901 BAXTER DR
PARKER CO
80134-9191
US

IV. Provider business mailing address

10901 BAXTER DR
PARKER CO
80134-9191
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-8653
  • Fax:
Mailing address:
  • Phone: 719-301-8653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2025351
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: