Provider Demographics
NPI:1245501246
Name:GIAQUINTO, YOLANDA S (RDH)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:S
Last Name:GIAQUINTO
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 1:1631 WETZEL AVE
Mailing Address - Street 2:BLDG 815
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4095
Mailing Address - Country:US
Mailing Address - Phone:719-526-5534
Mailing Address - Fax:719-526-5551
Practice Address - Street 1:1667 COCHRANE CIR BLDG 7495
Practice Address - Street 2:
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4603
Practice Address - Country:US
Practice Address - Phone:719-526-5537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH006984124Q00000X
PADH068066124Q00000X
CODH-905345124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist