Provider Demographics
NPI:1003222563
Name:DILLON, NIDA (DO)
Entity type:Individual
Prefix:DR
First Name:NIDA
Middle Name:
Last Name:DILLON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 STATE HIGHWAY 52 STE 240
Mailing Address - Street 2:
Mailing Address - City:DACONO
Mailing Address - State:CO
Mailing Address - Zip Code:80514-9107
Mailing Address - Country:US
Mailing Address - Phone:303-501-2600
Mailing Address - Fax:877-764-4622
Practice Address - Street 1:10550 QUIVIRA RD STE 405
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2304
Practice Address - Country:US
Practice Address - Phone:913-601-8962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014021710207Q00000X
KS05-40614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine