Provider Demographics
NPI:1932705811
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:NIEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-224-8171
Mailing Address - Street 1:2993 S. PEORIA ST SUITE 260
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:303-751-5700
Mailing Address - Fax:303-751-5222
Practice Address - Street 1:2993 S. PEORIA ST SUITE 260
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:303-751-5700
Practice Address - Fax:303-751-5222
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