Organization
INNER CITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CORTEZ (COO)
(720) 833-5099
Entity
Organization
Contact information
Practice address
3800 YORK ST, DENVER, CO 80205-3540
(303) 296-1767
(303) 296-3484
Mailing address
3800 YORK ST., DENVER, CO 80205-3972
(303) 296-1767
(303) 296-9313
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04001699
—
CO
01
—
04004552
MCD DENTAL
CO
01
—
14003031
NEW HOPE DENTAL SERVIC
CO
05
—
9000172845
—
CO
Enumeration date
02/24/2006
Last updated
01/22/2024
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