Provider Demographics
NPI:1679623243
Name:DUNKER, INNA E (DDS)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:E
Last Name:DUNKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:INNA
Other - Middle Name:A
Other - Last Name:ERMOLAEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2121 S ONEIDA ST
Mailing Address - Street 2:S-321
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2549
Mailing Address - Country:US
Mailing Address - Phone:303-796-8767
Mailing Address - Fax:303-694-6238
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:S-321
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2549
Practice Address - Country:US
Practice Address - Phone:303-796-8767
Practice Address - Fax:303-694-6238
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO73371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94278768Medicaid