Healthcare Provider Details

I. General information

NPI: 1841639879
Provider Name (Legal Business Name): AMY HUA BANKS D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY YOSHIDA HUA D.D.S

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 WATER VALLEY PKWY STE 101
WINDSOR CO
80550-6264
US

IV. Provider business mailing address

1349 WATER VALLEY PKWY STE 101
WINDSOR CO
80550-6264
US

V. Phone/Fax

Practice location:
  • Phone: 970-460-8989
  • Fax: 970-460-8989
Mailing address:
  • Phone: 970-460-8989
  • Fax: 970-460-8989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number203868
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: