Provider Demographics
NPI:1386653459
Name:AURORA YOUTH DENTISTRY, PC
Entity Type:Organization
Organization Name:AURORA YOUTH DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-886-0699
Mailing Address - Street 1:14251 E. 6TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011
Mailing Address - Country:US
Mailing Address - Phone:303-343-3133
Mailing Address - Fax:303-343-3139
Practice Address - Street 1:14251 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8706
Practice Address - Country:US
Practice Address - Phone:303-343-3133
Practice Address - Fax:303-343-3139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57553572Medicaid
CO1795651OtherUNITED CONCORDIA