Provider Demographics
NPI:1841905478
Name:TOTTEN, LENNON (RDH)
Entity type:Individual
Prefix:MRS
First Name:LENNON
Middle Name:
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W 3RD ST STE 103
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1401
Mailing Address - Country:US
Mailing Address - Phone:719-470-0745
Mailing Address - Fax:719-241-1950
Practice Address - Street 1:317 W 3RD ST, STE 103
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050
Practice Address - Country:US
Practice Address - Phone:719-470-0745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2025812124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty