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General NPI Number Information
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NPI Number | 1881496610
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Entity Type | Individual
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Provider Name | KAYLIN NICHELLE SHIFRAR RDH
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Gender | Female
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1335 6TH ST
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City | DEL NORTE
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State | CO
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Zip | 81132-3201
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Country | US
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Telephone | 719-657-1105
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Fax |
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Provider Business Mailing Address
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Address Line | 7772 N COUNTY ROAD 6 W
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City | DEL NORTE
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State | CO
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Zip | 81132-9609
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Country | US
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Telephone | 406-930-1954
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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 | 002024570
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License Number State | CO
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