Provider Demographics
NPI:1245451970
Name:CAPALBY, KIMBERLEY
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:CAPALBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 S UNIVERSITY BLVD
Mailing Address - Street 2:STE 240
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3196
Mailing Address - Country:US
Mailing Address - Phone:303-770-1106
Mailing Address - Fax:
Practice Address - Street 1:8170 S UNIVERSITY BLVD
Practice Address - Street 2:STE 240
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3196
Practice Address - Country:US
Practice Address - Phone:303-770-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO903424124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist