Provider Demographics
NPI:1710534888
Name:NINE TREASURES PLLC
Entity Type:Organization
Organization Name:NINE TREASURES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANUJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SURI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-773-9400
Mailing Address - Street 1:8120 S HOLLY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-4006
Mailing Address - Country:US
Mailing Address - Phone:303-773-9400
Mailing Address - Fax:303-773-9518
Practice Address - Street 1:8120 S HOLLY ST STE 102
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-4006
Practice Address - Country:US
Practice Address - Phone:303-773-9400
Practice Address - Fax:303-773-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32427034Medicaid