Provider Demographics
NPI:1720124241
Name:ACHERKAN, MAYYA (DDS)
Entity type:Individual
Prefix:
First Name:MAYYA
Middle Name:
Last Name:ACHERKAN
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 1:6950 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1618
Mailing Address - Country:US
Mailing Address - Phone:303-779-0265
Mailing Address - Fax:303-779-0266
Practice Address - Street 1:6950 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1618
Practice Address - Country:US
Practice Address - Phone:303-779-0265
Practice Address - Fax:303-779-0266
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO91191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice