Healthcare Provider Details

I. General information

NPI: 1609702083
Provider Name (Legal Business Name): VERDE MENTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

12801 CLERMONT ST
THORNTON CO
80241-2260
US

IV. Provider business mailing address

12801 CLERMONT ST
THORNTON CO
80241-2260
US

V. Phone/Fax

Practice location:
  • Phone: 805-317-9998
  • Fax:
Mailing address:
  • Phone: 805-317-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: MS. VIVIANA PATRICIA VASQUEZ TORRES
Title or Position: OWNER
Credential: RDH
Phone: 720-361-6107