Hero Dental of Lakewood PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HERO DENTAL OF LAKEWOOD PC

Doing business as

Adventure Dental, Vision and Orthodontics

Practice address

6695 W Colfax Ave
Lakewood, CO 80214-1805

Phone

(720) 279-2266

NPI assigned

Nov 23, 2020

Last updated

Nov 23, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

HERO DENTAL OF LAKEWOOD PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shaun Urbanozo

Title

Credentialing Manager

Phone

(719) 323-2362

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Adventure Dental, Vision and Orthodontics Doing business as

Tax ID family

Hero Dental of Lakewood PC2 organizations share this tax ID, including this one

Part of

Hero Dental of Lakewood PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hero Dental of Lakewood PC

  dba Adventure Dental, Vision and Orthodontics

  • Dentist
  • Lakewood, CO
  • NPI 1902282361
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Hero Dental of Lakewood PC

  dba Adventure Dental, Vision and Orthodontics

  • Dentist
  • Lakewood, CO
  • NPI 1902282361
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1588268361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6695 W COLFAX AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802141805",
            "telephone_number": "720-279-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERO DENTAL OF LAKEWOOD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERO DENTAL OF LAKEWOOD PC",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "URBANOZO",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-323-2362"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94158002",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventure Dental, Vision and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marti J Hernandez, BSN RN PHNII CLC
• Michele Hernandez, RBT
• Rosemary Hernandez
• Sadyee Hernandez
• Stacy Dianne Hernandez, RN
• Hero Dental of Lakewood PC (Adventure Dental, Vision and Orthodontics)
• Daniel J Heron, BCBA
• Derek Herra, MD
• Tamara Jo Herremans, D.D.S.
• Corina Herrera

• General Practice Dentistry in Lakewood, CO
• Providers in Lakewood, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.