Provider Demographics
NPI:1083318554
Name:ADAIME, SHANIE MARIE (RDH)
Entity Type:Individual
Prefix:
First Name:SHANIE
Middle Name:MARIE
Last Name:ADAIME
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:SHANIE
Other - Middle Name:MARIE
Other - Last Name:ADAIME ORTIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10260 N. WASHINGTON ST
Mailing Address - Street 2:APT 1625
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229
Mailing Address - Country:US
Mailing Address - Phone:575-636-4613
Mailing Address - Fax:
Practice Address - Street 1:501 28TH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3003
Practice Address - Country:US
Practice Address - Phone:303-602-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLOCAL.0001665124Q00000X
CODH.002025355124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist