Provider Demographics
NPI:1639961717
Name:ESQUIVEZ, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ESQUIVEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-8825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:BENNETT
Practice Address - State:CO
Practice Address - Zip Code:80102-8825
Practice Address - Country:US
Practice Address - Phone:303-558-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00206309122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist