Provider Demographics
NPI:1427934512
Name:LOTUS DENTAL PLLC
Entity type:Organization
Organization Name:LOTUS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLAVA TEERDHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:802-734-8550
Mailing Address - Street 1:7479 E 29TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2704
Mailing Address - Country:US
Mailing Address - Phone:303-321-4445
Mailing Address - Fax:
Practice Address - Street 1:7479 E 29TH PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2704
Practice Address - Country:US
Practice Address - Phone:303-321-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty