Provider Demographics
NPI:1841508132
Name:HENRY D. AHN DMD PC
Entity type:Organization
Organization Name:HENRY D. AHN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-750-3737
Mailing Address - Street 1:11275 E MISSISSIPPI AVE STE 2N
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3263
Mailing Address - Country:US
Mailing Address - Phone:303-750-3737
Mailing Address - Fax:303-751-2285
Practice Address - Street 1:11275 E MISSISSIPPI AVE STE 2N
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3263
Practice Address - Country:US
Practice Address - Phone:303-750-3737
Practice Address - Fax:303-751-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23124377Medicaid