Provider Demographics
NPI:1629646054
Name:CARREON ARMENDARIZ, STEFANY
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:CARREON ARMENDARIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15626 E 51ST PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5678
Mailing Address - Country:US
Mailing Address - Phone:720-232-5407
Mailing Address - Fax:
Practice Address - Street 1:15626 E 51ST PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5678
Practice Address - Country:US
Practice Address - Phone:720-232-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002026097124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist