Provider Demographics
NPI:1952944720
Name:UMPHLETT-ARENS DDS, PLLC
Entity Type:Organization
Organization Name:UMPHLETT-ARENS DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARENS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-649-3397
Mailing Address - Street 1:2500 SAWMILL RD APT 525
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5687
Mailing Address - Country:US
Mailing Address - Phone:402-649-3397
Mailing Address - Fax:
Practice Address - Street 1:5145 CENTENNIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-4426
Practice Address - Country:US
Practice Address - Phone:719-593-0263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental