MEDICARE: WEST DENVER ENDOCRINOLOGY LLC

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1770097073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST DENVER ENDOCRINOLOGY LLC

Provider Business Mailing Address
First Line	:	215 S WADSWORTH BLVD STE 530
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1566
Country	:	US
Telephone Number	:	303-396-4695
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 S WADSWORTH BLVD STE 530
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1566
Country	:	US
Telephone Number	:	303-396-4695
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY RIENIETS
Credential	:	DO
Telephone Number	:	303-396-4695

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	08/05/2022

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