Healthcare Provider Details

I. General information

NPI: 1083407837
Provider Name (Legal Business Name): EMMA PICKUP DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 W US HIGHWAY 50
SALIDA CO
81201-9344
US

IV. Provider business mailing address

224 W RAINBOW BLVD PMB 219
SALIDA CO
81201-2347
US

V. Phone/Fax

Practice location:
  • Phone: 719-539-2587
  • Fax:
Mailing address:
  • Phone: 512-954-7884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number00206592
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: