Provider Demographics
NPI:1346021318
Name:OWEN, CANDACE (RDH, MS, MPH)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:OWEN
Suffix:
Gender:F
Credentials:RDH, MS, MPH
Other - Prefix:
Other - First Name:CANDACE
Other - Middle Name:
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6915 E 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8153
Mailing Address - Country:US
Mailing Address - Phone:719-588-2090
Mailing Address - Fax:
Practice Address - Street 1:2205 W 136TH AVE # 106-159
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9306
Practice Address - Country:US
Practice Address - Phone:708-650-6229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002024860124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist