MEDICARE: SARAH DIPASQUALE RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	DH.000906123	CO

General Provider Information

NPI Number	:	1720815533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DIPASQUALE RDH

Provider Business Mailing Address
First Line	:	5245 CENTENNIAL BLVD STE 207
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-4405
Country	:	US
Telephone Number	:	719-402-3232
Fax Number	:

Provider Business Practice Location Address
First Line	:	5245 CENTENNIAL BLVD STE 207
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-4405
Country	:	US
Telephone Number	:	719-402-3232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	04/21/2026

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