Healthcare Provider Details

I. General information

NPI: 1447125760
Provider Name (Legal Business Name): CHINA DORA MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 HURON ST
THORNTON CO
80260-6805
US

IV. Provider business mailing address

8820 HURON ST
THORNTON CO
80260-6805
US

V. Phone/Fax

Practice location:
  • Phone: 303-386-7622
  • Fax:
Mailing address:
  • Phone: 303-386-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number1668839
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: