Provider Demographics
NPI:1801273776
Name:NOOR, ERADA (DDS)
Entity type:Individual
Prefix:DR
First Name:ERADA
Middle Name:
Last Name:NOOR
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 1:2120 BLAKE ST
Mailing Address - Street 2:APT 636
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16900 E QUINCY AVE
Practice Address - Street 2:UNIT B
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-3299
Practice Address - Country:US
Practice Address - Phone:303-617-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202604122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program