Provider Demographics
NPI:1376228767
Name:BATRES, BRENDA (DDS)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:BATRES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 S PARK TERRACE AVE UNIT 202A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3387
Mailing Address - Country:US
Mailing Address - Phone:719-243-8118
Mailing Address - Fax:
Practice Address - Street 1:12357 E CORNELL AVE # 10
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3323
Practice Address - Country:US
Practice Address - Phone:303-337-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX395021223G0001X
CODEN.00205715122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice