Provider Demographics
NPI:1114523099
Name:EMBRACEKIDS II, LLC
Entity Type:Organization
Organization Name:EMBRACEKIDS II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-224-8171
Mailing Address - Street 1:6390 GARDENIA STREET SUITE 200
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004
Mailing Address - Country:US
Mailing Address - Phone:303-421-2616
Mailing Address - Fax:303-456-4046
Practice Address - Street 1:6390 GARDENIA STREET SUITE 200
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004
Practice Address - Country:US
Practice Address - Phone:303-421-2616
Practice Address - Fax:303-456-4046
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMBRACEKIDS II, LLC DBA: COLORADO ORTHODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty