Provider Demographics
NPI:1710380472
Name:HAMZEH, YASMIN MOHEBI (RDH)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:MOHEBI
Last Name:HAMZEH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 YORK ST.
Mailing Address - Street 2:INNER CITY HEALTH CENTER
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3972
Mailing Address - Country:US
Mailing Address - Phone:303-296-4873
Mailing Address - Fax:303-382-2808
Practice Address - Street 1:3800 YORK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205
Practice Address - Country:US
Practice Address - Phone:303-382-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH000905486124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34482229Medicaid