Provider Demographics
NPI:1407241011
Name:DOKKEN, PRIYA (DO)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:DOKKEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 N TOWER RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8024
Mailing Address - Country:US
Mailing Address - Phone:720-734-8816
Mailing Address - Fax:720-405-4454
Practice Address - Street 1:5680 N TOWER RD STE 120
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8024
Practice Address - Country:US
Practice Address - Phone:720-734-8816
Practice Address - Fax:720-405-4454
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0060840208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program