Provider Demographics
NPI:1376196782
Name:ZHU, CONAN
Entity Type:Individual
Prefix:
First Name:CONAN
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1471 27TH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2243
Mailing Address - Country:US
Mailing Address - Phone:636-751-8584
Mailing Address - Fax:
Practice Address - Street 1:10650 GARDEN DR UNIT 106
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-7019
Practice Address - Country:US
Practice Address - Phone:303-366-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002041141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice