MEDICARE: SARAH E VILLASENOR DDS 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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1952037285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH E VILLASENOR DDS LLC

Provider Business Mailing Address
First Line	:	1780 S BELLAIRE ST STE 655
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4328
Country	:	US
Telephone Number	:	303-758-0223
Fax Number	:

Provider Business Practice Location Address
First Line	:	1780 S BELLAIRE ST STE 655
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4328
Country	:	US
Telephone Number	:	303-758-0223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH VILLASENOR
Credential	:	DDS
Telephone Number	:	303-758-0223

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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