Provider Demographics
NPI:1992997209
Name:RASOULI, JINA K (DDS)
Entity type:Individual
Prefix:
First Name:JINA
Middle Name:K
Last Name:RASOULI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JINA
Other - Middle Name:
Other - Last Name:DOWLATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:38 BLUE HERON DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-4101
Mailing Address - Country:US
Mailing Address - Phone:720-232-3095
Mailing Address - Fax:
Practice Address - Street 1:7901 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2032
Practice Address - Country:US
Practice Address - Phone:303-331-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9508122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist