Mariah O'Connell, RDH

Individual provider Active NPI Dental Hygienist · Fort Lupton, CO

NPI 1619475159 · NPPES record last updated Jun 8, 2020

Key facts

NPI
1619475159
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
Practice address
203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone
(303) 892-6401
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X CO Yes

Addresses

Primary practice location

203 S Rollie Ave
Fort Lupton, CO 80621-1508

Mailing address

1530 Wildflower CT
Brighton, CO 80601-6794

Other practice location 1

1530 Wildflower Ct
Brighton, CO 80601-6794
Phone (720) 435-3355

Other providers in Fort Lupton, CO

All providers in Fort Lupton, CO · Dental Hygienist in Colorado

Sources for this page

Verify at the official NPI Registry.