Basic Information
| Provider Information | |||||||||
| NPI: | 1164707899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAPLAN | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7560 RANGEWOOD DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809204199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195963113 | ||||||||
| FaxNumber: | 7195963254 | ||||||||
| Practice Location | |||||||||
| Address1: | 703 N TEJON ST | ||||||||
| Address2: | SUITE E | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809031094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196359610 | ||||||||
| FaxNumber: | 7196355072 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2011 | ||||||||
| LastUpdateDate: | 12/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 10588 | CO | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
ID Information
| ID | Type | State | Issuer | Description | 45-3417167 | 01 | CO | FEIN | OTHER |