Provider Demographics
NPI:1467657379
Name:MILOT, JENNIFER (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MILOT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:MILOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:15530 W 64TH AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6874
Mailing Address - Country:US
Mailing Address - Phone:303-422-3742
Mailing Address - Fax:303-422-5811
Practice Address - Street 1:15530 W 64TH AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-6874
Practice Address - Country:US
Practice Address - Phone:303-422-3742
Practice Address - Fax:303-422-5811
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO94091223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69180075Medicaid