Greeley Orthodontic Center

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

594 Issued in CO

Legal business name

GREELEY ORTHODONTIC CENTER

Practice address

2021 Clubhouse Dr
Suite 110
Greeley, CO 80634-3667

Phone

(970) 330-2500

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Gary Joseph Kloberdanz, DDS/MS

Title

President

Phone

(970) 330-2500

Specialties & licenses 1

Addresses

Tax ID family

Fort Morgan Orthodontic Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fort Morgan Orthodontic Center

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Morgan, CO
  • NPI 1598188450
  NPD tax ID

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962401216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 CLUBHOUSE DR",
            "address_2": "SUITE 110",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343667",
            "telephone_number": "970-330-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CLUBHOUSE DR",
            "address_2": "SUITE 110",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343667",
            "telephone_number": "970-330-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREELEY ORTHODONTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLOBERDANZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-330-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS/MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greeley Medical Clinic
• Greeley Medical Clinic
• Greeley Medical Clinic PC
• Greeley Memory Care LLC
• Greeley Modern Dentistry, LLP
• Greeley Prosthodontics
• Greeley Xray Group PC
• Thomas Greeley, LCSW
• Stephanie Green
• Connie Marlene Greenhood, MSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Greeley, CO
• Providers in Greeley, 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 Aug 22, 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.