Provider Demographics
NPI:1720215882
Name:LASIK, JAMIE KRISTEN (RDH)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:KRISTEN
Last Name:LASIK
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 1:4243 E 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-6916
Mailing Address - Country:US
Mailing Address - Phone:720-274-1380
Mailing Address - Fax:720-274-1381
Practice Address - Street 1:4243 E 136TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-6916
Practice Address - Country:US
Practice Address - Phone:720-274-1380
Practice Address - Fax:720-274-1381
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905274124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist