Provider Demographics
NPI:1043903800
Name:THOMPSON, TRACI C (DH)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 FALCON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2901
Mailing Address - Country:US
Mailing Address - Phone:720-985-7057
Mailing Address - Fax:
Practice Address - Street 1:3800 N YORK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3540
Practice Address - Country:US
Practice Address - Phone:303-296-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002026758124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist