Provider Demographics
NPI:1497322390
Name:CARREIRA, MICHELE (DENTAL HYGIENIST)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:CARREIRA
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 621282
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80162-1282
Mailing Address - Country:US
Mailing Address - Phone:774-283-2149
Mailing Address - Fax:
Practice Address - Street 1:8204 S KIPLING PKWY UNIT 160
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6337
Practice Address - Country:US
Practice Address - Phone:720-923-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002024649124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO002024649Medicaid