Provider Demographics
NPI:1699036715
Name:PAIGE, DENNIS EDMUND (CSFA)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:EDMUND
Last Name:PAIGE
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4047
Mailing Address - Country:US
Mailing Address - Phone:303-815-4708
Mailing Address - Fax:
Practice Address - Street 1:1079 JOLIET ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-4047
Practice Address - Country:US
Practice Address - Phone:303-815-4708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
COSA-1568174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialist
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty