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General NPI Number Information
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NPI Number | 1205357118
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Entity Type | Individual
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Provider Name | HEATHER SCHENKEL RDH
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Gender | Female
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 1920 VINDICATOR DR STE 211
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-3625
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Country | US
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Telephone | 719-314-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 7207 RED CARDINAL LOOP
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-5634
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Country | US
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Telephone | 719-502-9433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 002024813
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License Number State | CO
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