Provider Demographics
NPI:1295545077
Name:BANU, TAHSEENA (DDS)
Entity type:Individual
Prefix:
First Name:TAHSEENA
Middle Name:
Last Name:BANU
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 1:4552 S VALDAI WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6817
Mailing Address - Country:US
Mailing Address - Phone:916-396-4142
Mailing Address - Fax:
Practice Address - Street 1:4552 S VALDAI WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-6817
Practice Address - Country:US
Practice Address - Phone:916-396-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00206190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist