Provider Demographics
NPI:1619576428
Name:KIDS IN NEED OF DENTISTRY
Entity Type:Organization
Organization Name:KIDS IN NEED OF DENTISTRY
Other - Org Name:KIND - MDDS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-795-9791
Mailing Address - Street 1:7190 COLORADO BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1808
Mailing Address - Country:US
Mailing Address - Phone:303-733-3710
Mailing Address - Fax:
Practice Address - Street 1:925 N LINCOLN ST STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2784
Practice Address - Country:US
Practice Address - Phone:720-619-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDS IN NEED OF DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-22
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental