Basic Information
Provider Information
NPI: 1699080291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOLAND
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3701 S BROADWAY
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801133611
CountryCode: US
TelephoneNumber: 3037611977
FaxNumber: 3037612787
Practice Location
Address1: 3701 S BROADWAY
Address2:  
City: ENGLEWOOD
State: CO
PostalCode: 801133611
CountryCode: US
TelephoneNumber: 3033606276
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/09/2010
LastUpdateDate: 08/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000XDEN4152MEN Dental ProvidersDentist 
122300000XDEN.00010085COY Dental ProvidersDentist 

No ID Information.


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