Provider Demographics
NPI:1861058562
Name:KAUFMAN, MEGAN BREANNA
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BREANNA
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:BREANNA
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10016 CRYSTAL CIR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9559
Mailing Address - Country:US
Mailing Address - Phone:720-725-5623
Mailing Address - Fax:
Practice Address - Street 1:10016 CRYSTAL CIR
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9559
Practice Address - Country:US
Practice Address - Phone:720-725-5623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant