Provider Demographics
NPI:1457715062
Name:LOZA SALINAS, JESUS (DDS)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:LOZA SALINAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 E 7TH AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-3836
Mailing Address - Country:US
Mailing Address - Phone:954-609-6611
Mailing Address - Fax:
Practice Address - Street 1:1345 PLAZA CT N STE 1A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2832
Practice Address - Country:US
Practice Address - Phone:303-665-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002027931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice