Provider Demographics
NPI:1972162592
Name:TARJAN, NEDA (DDS)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:TARJAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9461 GREEN ISLAND PL
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3146
Mailing Address - Country:US
Mailing Address - Phone:720-445-2550
Mailing Address - Fax:
Practice Address - Street 1:6955 S YORK ST STE 415
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3277
Practice Address - Country:US
Practice Address - Phone:303-226-6290
Practice Address - Fax:303-226-6291
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00204026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist