Provider Demographics
NPI:1609509041
Name:MUNOZ, CRYSTAL JASMINE (DDS)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:JASMINE
Last Name:MUNOZ
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 1:9640 REUNION PKWY
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9070
Mailing Address - Country:US
Mailing Address - Phone:307-575-3217
Mailing Address - Fax:
Practice Address - Street 1:9640 REUNION PKWY
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9070
Practice Address - Country:US
Practice Address - Phone:307-575-3217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002051791223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice