Provider Demographics
NPI:1730477852
Name:PIPKIN, SHIRA L (OD)
Entity Type:Individual
Prefix:DR
First Name:SHIRA
Middle Name:L
Last Name:PIPKIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:L
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13605 XAVIER LN
Mailing Address - Street 2:STE G
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3603
Mailing Address - Country:US
Mailing Address - Phone:303-951-1820
Mailing Address - Fax:303-951-1826
Practice Address - Street 1:13605 XAVIER LN
Practice Address - Street 2:STE G
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3603
Practice Address - Country:US
Practice Address - Phone:303-951-1820
Practice Address - Fax:303-951-1826
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist