Provider Demographics
NPI:1396942793
Name:NIKITOW, DENNIS PETER (DC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:PETER
Last Name:NIKITOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 INVERNESS DR E
Mailing Address - Street 2:STE 120
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5155
Mailing Address - Country:US
Mailing Address - Phone:303-773-8027
Mailing Address - Fax:303-694-3071
Practice Address - Street 1:99 INVERNESS DR E
Practice Address - Street 2:STE 120
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5155
Practice Address - Country:US
Practice Address - Phone:303-773-8027
Practice Address - Fax:303-694-3071
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC11673Medicare ID - Type Unspecified