Provider Demographics
NPI:1720753353
Name:BROWN, NAGAPOORNIMA RACHEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAGAPOORNIMA
Middle Name:RACHEL
Last Name:BROWN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NAGAPOORNIMA
Other - Middle Name:RACHEL
Other - Last Name:PADMANABHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:8240 COUNTY ROAD 115 UNIT 5
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-9089
Mailing Address - Country:US
Mailing Address - Phone:913-481-8157
Mailing Address - Fax:
Practice Address - Street 1:371 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-8399
Practice Address - Country:US
Practice Address - Phone:970-927-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002048701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice