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NPI Code Detail

MEDICARE: MONA KHALEDI

MEDICARE: MONA KHALEDI
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
1122300000XDentistDEN.00206343CO

General Provider Information

NPI Number : 1912898305
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA KHALEDI
Provider Business Mailing Address
First Line : 414 SMITH CIR
Second Line :
City : ERIE
State : CO
Zip : 80516-8469
Country : US
Telephone Number : 971-320-9307
Fax Number :
Provider Business Practice Location Address
First Line : 1234 S HOVER ST STE 100
Second Line :
City : LONGMONT
State : CO
Zip : 80501-7962
Country : US
Telephone Number : 720-907-8770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2025
Last Update Date : 07/14/2025

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Directions to “ MONA KHALEDI ” Practice Location

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