Hero Dental of Longmont PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HERO DENTAL OF LONGMONT PC

Doing business as

Adventure Dental, Vision and Orthodontics

Practice address

1739 Main St
Longmont, CO 80501-2035

Phone

(303) 834-6400

NPI assigned

Nov 23, 2020

Organization subpart

Yes

Parent organization

HERO DENTAL OF LONGMONT 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 Longmont PC2 organizations share this tax ID, including this one

Part of

Hero Dental of Longmont PC

Other organizations with this tax ID 1

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

• Hero Dental of Longmont PC

  dba Adventure Dental, Vision and Orthodontics

  • General Practice Dentistry
  • Longmont, CO
  • NPI 1205131430
  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 Longmont PC

  dba Adventure Dental, Vision and Orthodontics

  • General Practice Dentistry
  • Longmont, CO
  • NPI 1205131430
  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": "1790389583",
    "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": "1739 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012035",
            "telephone_number": "303-834-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERO DENTAL OF LONGMONT PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERO DENTAL OF LONGMONT 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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95787089",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventure Dental, Vision and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Jo Herbstreith
• Haley Jayne Herman, NP
• Mercedes Hernandez, PHARM.D
• Noelle L Hernandez
• Hero Dental of Longmont PC (Adventure Dental, Vision and Orthodontics)
• Hero Vision of Longmont, LLC (Adventure Dental Vision and Orthondontics)
• Hero Vision of Longmont, LLC (Adventure Vision)
• Michelle Jo Herren
• Laura Esther Herrera, DPT
• Maria Mildred Herrera, MD

• General Practice Dentistry in Longmont, CO
• Providers in Longmont, 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.