Provider Demographics
NPI:1851532568
Name:OGAN, ELENA (DMD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:OGAN
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 1:6665 GLADE PARK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4722
Mailing Address - Country:US
Mailing Address - Phone:916-677-9097
Mailing Address - Fax:
Practice Address - Street 1:219 W COLORADO AVE STE 206
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3338
Practice Address - Country:US
Practice Address - Phone:719-447-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00205889122300000X
NJ22DI02401300122300000X
CADDS1009841223G0001X
PADS039391122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice