Provider Demographics
NPI:1659170454
Name:FOX CREEK FAMILY DENTAL WESTMINSTER
Entity type:Organization
Organization Name:FOX CREEK FAMILY DENTAL WESTMINSTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MANAGEMEN
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-331-8371
Mailing Address - Street 1:7995 E PRENTICE AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2713
Mailing Address - Country:US
Mailing Address - Phone:307-331-8371
Mailing Address - Fax:
Practice Address - Street 1:6415 W 104TH AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-4118
Practice Address - Country:US
Practice Address - Phone:720-961-7842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESPIRE DENTAL HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty