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General NPI Number Information
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NPI Number | 1609447762
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Entity Type | Individual
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Provider Name | DALLIN ISAAC BASSETT OD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 6501 E BELLEVIEW AVE STE 140
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City | ENGLEWOOD
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State | CO
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Zip | 80111-6020
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Country | US
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Telephone | 303-202-0669
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Fax |
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Provider Business Mailing Address
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Address Line | 16678 E PRENTICE AVE
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City | CENTENNIAL
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State | CO
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Zip | 80015-4122
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Country | US
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Telephone | 832-613-1096
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003679
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License Number State | CO
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