=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336526359
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERENI MAIA SILVA RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/28/2015
-----------------------------------------------------
Last Update Date | 04/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1250 S BUCKLEY RD
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80017-4180
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-337-3300
-----------------------------------------------------
Fax | 303-337-3301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1250 S BUCKLEY RD UNIT M
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80017-5120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-337-3300
-----------------------------------------------------
Fax | 303-337-3301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | DH002023775
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------