Provider Demographics
NPI:1669094082
Name:ARCENEAUX, KARA DAWN
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:DAWN
Last Name:ARCENEAUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12999 W BOWLES DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4641
Mailing Address - Country:US
Mailing Address - Phone:303-625-7997
Mailing Address - Fax:
Practice Address - Street 1:12999 W BOWLES DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4641
Practice Address - Country:US
Practice Address - Phone:303-625-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204764122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program