Provider Demographics
NPI:1972061984
Name:PAULSEN, ELIZABETH (DDS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PAULSEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4262 ROYAL PINE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2824
Mailing Address - Country:US
Mailing Address - Phone:415-990-6229
Mailing Address - Fax:
Practice Address - Street 1:4262 ROYAL PINE DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-2824
Practice Address - Country:US
Practice Address - Phone:415-990-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0260571223P0221X, 122300000X
CODEN.002046891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000213171Medicaid