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General NPI Number Information
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NPI Number | 1689112187
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Entity Type | Individual
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Provider Name | AILAR BAGHERDAEI
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Gender | Female
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 5120 S BROADWAY STE B
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City | ENGLEWOOD
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State | CO
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Zip | 80113-9304
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Country | US
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Telephone | 303-794-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 BROADWAY STE B
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City | DENVER
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State | CO
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Zip | 80216-2094
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Country | US
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Telephone | 303-793-0044
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS039513
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DEN.00203254
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License Number State | CO
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