Provider Demographics
NPI:1356381040
Name:FLOREZ, TANIA BELAKHOVSKY (DDS)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:BELAKHOVSKY
Last Name:FLOREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:TANIA
Other - Middle Name:FLOREZ
Other - Last Name:HANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:769 RACE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3731
Mailing Address - Country:US
Mailing Address - Phone:303-618-5859
Mailing Address - Fax:
Practice Address - Street 1:769 RACE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3731
Practice Address - Country:US
Practice Address - Phone:303-618-5859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice