Provider Demographics
NPI:1336697721
Name:TRIPPEL, REINUKA
Entity Type:Individual
Prefix:
First Name:REINUKA
Middle Name:
Last Name:TRIPPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 S UNIVERSITY BLVD STE C-2
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2885
Mailing Address - Country:US
Mailing Address - Phone:303-220-8075
Mailing Address - Fax:
Practice Address - Street 1:5900 S UNIVERSITY BLVD STE C-2
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80121-2885
Practice Address - Country:US
Practice Address - Phone:303-220-8075
Practice Address - Fax:720-710-1375
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist