Provider Demographics
NPI:1215166137
Name:TATAJE, YVETTE ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:ELIZABETH
Last Name:TATAJE
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 1:1685 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8705
Mailing Address - Country:US
Mailing Address - Phone:970-667-2121
Mailing Address - Fax:970-667-2323
Practice Address - Street 1:1685 ROCKY MOUNTAIN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8705
Practice Address - Country:US
Practice Address - Phone:970-667-2121
Practice Address - Fax:970-667-2323
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS69151223G0001X
MO0156321223G0001X
CO10122122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice