Provider Demographics
NPI:1225415300
Name:TALLER, CELINE (DMD)
Entity type:Individual
Prefix:DR
First Name:CELINE
Middle Name:
Last Name:TALLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CELINE
Other - Middle Name:
Other - Last Name:JAVANNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:8301 E PRENTICE AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2990
Mailing Address - Country:US
Mailing Address - Phone:720-606-4220
Mailing Address - Fax:720-606-4221
Practice Address - Street 1:8301 E PRENTICE AVE STE 215
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2990
Practice Address - Country:US
Practice Address - Phone:720-606-4220
Practice Address - Fax:720-606-4221
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002039851223D0004X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology