Provider Demographics
NPI:1639686967
Name:SIERRA, MICHELLE ROZ (RDH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ROZ
Last Name:SIERRA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 W HOLDEN PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-3353
Mailing Address - Country:US
Mailing Address - Phone:303-953-6600
Mailing Address - Fax:
Practice Address - Street 1:2880 W HOLDEN PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3353
Practice Address - Country:US
Practice Address - Phone:303-953-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002024777124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist