Provider Demographics
NPI:1710066972
Name:ZINK, AURORA VIRGEN (DDS)
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:VIRGEN
Last Name:ZINK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:AURORA
Other - Middle Name:EIKO
Other - Last Name:VIRGEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:2221 E BIJOU ST STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-8009
Mailing Address - Country:US
Mailing Address - Phone:719-576-1850
Mailing Address - Fax:719-955-3470
Practice Address - Street 1:5000 MENAUL BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3046
Practice Address - Country:US
Practice Address - Phone:505-872-1212
Practice Address - Fax:505-872-1213
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD28441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM50624865Medicaid