Provider Demographics
NPI:1679047120
Name:DENVER SKIN DOCTORS, LLC
Entity Type:Organization
Organization Name:DENVER SKIN DOCTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZEINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-743-7970
Mailing Address - Street 1:1938 S GILPIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3308
Mailing Address - Country:US
Mailing Address - Phone:612-743-7970
Mailing Address - Fax:
Practice Address - Street 1:4500 E 9TH AVE STE 640
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3925
Practice Address - Country:US
Practice Address - Phone:612-743-7970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty