Provider Demographics
NPI:1881496610
Name:SHIFRAR, KAYLIN NICHELLE (RDH)
Entity type:Individual
Prefix:MRS
First Name:KAYLIN
Middle Name:NICHELLE
Last Name:SHIFRAR
Suffix:
Gender:
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7772 N COUNTY ROAD 6 W
Mailing Address - Street 2:
Mailing Address - City:DEL NORTE
Mailing Address - State:CO
Mailing Address - Zip Code:81132-9609
Mailing Address - Country:US
Mailing Address - Phone:406-930-1954
Mailing Address - Fax:
Practice Address - Street 1:1335 6TH ST
Practice Address - Street 2:
Practice Address - City:DEL NORTE
Practice Address - State:CO
Practice Address - Zip Code:81132-3201
Practice Address - Country:US
Practice Address - Phone:719-657-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002024570124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist