Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | DD3159 | NM |
N | 213EG0000X | General Practice | DD3159 | NM |
Y | 1223P0221X | Pediatric Dentist | DEN.00202655 | CO |
NPI | 1104151141 |
---|---|
Provider Name | Dr. Heather L. Jenkins |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2009 |
Last Update Date | 19/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000144877 | (05) | CO |