Provider Demographics
NPI:1659007219
Name:CHAVEZ, JULIA (RDH, OMT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 S OAKLAND CIR E
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3135
Mailing Address - Country:US
Mailing Address - Phone:303-815-9005
Mailing Address - Fax:
Practice Address - Street 1:2818 S OAKLAND CIR E
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3135
Practice Address - Country:US
Practice Address - Phone:303-815-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905074124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist