Northglenn Grin Ortho, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

NORTHGLENN GRIN ORTHO, PLLC

Practice address

420 E 120TH Ave Ste B11
Northglenn, CO 80233-1113

Phone

(720) 453-3277

Fax

(303) 330-0714

NPI assigned

Jul 16, 2024

Organization subpart

No

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

Authorized official

Name

Colton Flake, DDS

Title

Managing Partner

Phone

(720) 579-8855

Specialties & licenses 1

Addresses

Other names 1

• GRiN Orthodontics of Northglenn Doing business as

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1720826795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7999 S COUNTRY CLUB PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800161195",
            "telephone_number": "720-579-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 120TH AVE STE B11",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331113",
            "telephone_number": "720-453-3277",
            "fax_number": "303-330-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHGLENN GRIN ORTHO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "FLAKE",
        "authorized_official_first_name": "COLTON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "720-579-8855",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRiN Orthodontics of Northglenn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRiN Orthodontics of Northglenn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.