EMBRACEABLE AZ LLC (NPI# 1851644504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851644504 |
| Entity Type | Organization |
| Organization Name | EMBRACEABLE AZ LLC |
| Other Organization Name | COMFORT BRACES WEST MESA |
| Practice Address |
1130 S Country Club Dr Suite 101 Mesa AZ 85210-4639 |
| Practice Telephone | 4804619866 |
| Mailing Telephone | 4804619866 |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |
| Authorized Official Name | DR. MARK STASI (PARTNER / OWNER) |
| Authorized Official Telephone | 3035491912 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
8340 | AZ | Dental Providers |
| Other Name | Type Code |
|---|---|
| Comfort Braces West Mesa | Doing Business As Name - Organization |
| Street Address |
1130 S COUNTRY CLUB DR SUITE 101 |
| City | MESA |
| State | AZ |
| Zip Code | 85210-4639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144756016 | Tad Olsen | Dentist | 1130 S Country Club Dr, Mesa, AZ 85210-4639 | 2017-05-11 |
| 1376926303 | Jared Spencer Smith | Dentist | 1130 S Country Club Dr, Mesa, AZ 85210-4639 | 2015-07-08 |
| 1669883807 | Justin Van Dusen | Dentist | 1130 S Country Club Dr, Mesa, AZ 85210-4639 | 2014-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174091342 | East Valley Orthodontics | Dentist | 1635 N Greenfield Rd Ste 103, Mesa, AZ 85205-4010 | 2018-11-06 |
| 1255758983 | Braces R Us | Dentist | 1702 S Val Vista Dr # 101, Mesa, AZ 85204-7304 | 2014-03-19 |
| 1649424342 | Jason Knapp Judd | Dentist | 1942 E Southern Ave, Mesa, AZ 85204-5245 | 2008-11-06 |
| 1023276649 | S. Ryan Young, Dmd Cags Pllc | Dentist | 1702 S Val Vista Dr, Suite 101, Mesa, AZ 85204-7304 | 2008-05-30 |
| 1952585507 | Alan Mark Petersen | Dentist | 6755 E Superstition Springs Blvd Ste 201, Mesa, AZ 85206-4374 | 2007-12-18 |
| 1144410259 | James H Plets | Dentist | 2150 South Dobson Road, Suite #3, Mesa, AZ 85202 | 2007-07-26 |
| 1467674481 | Jack G Wright | Dentist | 453 W 5th St, Mesa, AZ 85201-5703 | 2007-05-02 |
| 1578694659 | Gregory Garn | Dentist | 2835 E Brown Rd Ste 102, Mesa, AZ 85213-5470 | 2007-03-08 |
| 1952479230 | Steven Ryan Young | Dentist | 1702 S Val Vista Dr Ste 101, Mesa, AZ 85204-7304 | 2006-12-02 |
| 1437234135 | Keith Macdonald | Dentist | 5753 E Brown Rd, Suite 101, Mesa, AZ 85205-4411 | 2006-10-25 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.