Provider Demographics
NPI:1639914823
Name:WIPF, LAUREN KRISTINE (DDS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KRISTINE
Last Name:WIPF
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 1:3004 GALENA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3351
Mailing Address - Country:US
Mailing Address - Phone:425-281-5924
Mailing Address - Fax:
Practice Address - Street 1:11355 S PARKER RD UNIT 105
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7705
Practice Address - Country:US
Practice Address - Phone:303-805-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00206046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist