Provider Demographics
NPI:1851855084
Name:EMBRACE DENTAL
Entity Type:Organization
Organization Name:EMBRACE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN VINH
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:775-391-6212
Mailing Address - Street 1:4760 GALLERIA PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9613
Mailing Address - Country:US
Mailing Address - Phone:775-391-6212
Mailing Address - Fax:
Practice Address - Street 1:4760 GALLERIA PKWY STE 102-104
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-9619
Practice Address - Country:US
Practice Address - Phone:702-292-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1225408701Medicaid