MEDICARE: ELIZABETH PAULSEN DDS

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	30.026057	OH
2	1223P0221X	Pediatric Dentistry	DEN.00204689	CO
3	122300000X	Dentist	30.026057	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972061984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PAULSEN DDS

Provider Business Mailing Address
First Line	:	4262 ROYAL PINE DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-2824
Country	:	US
Telephone Number	:	415-990-6229
Fax Number	:

Provider Business Practice Location Address
First Line	:	4262 ROYAL PINE DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-2824
Country	:	US
Telephone Number	:	415-990-6229
Fax Number	:

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

Provider Enumeration Date	:	03/08/2019
Last Update Date	:	08/08/2025

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