Provider Demographics
NPI:1427756428
Name:VELITSKAYA, MAYYA (DMD)
Entity type:Individual
Prefix:
First Name:MAYYA
Middle Name:
Last Name:VELITSKAYA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 E FAIRMOUNT DR UNIT 626
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6831
Mailing Address - Country:US
Mailing Address - Phone:720-207-8254
Mailing Address - Fax:
Practice Address - Street 1:63 N QUEBEC ST STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7358
Practice Address - Country:US
Practice Address - Phone:720-446-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002059181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice