Provider Demographics
NPI:1518017151
Name:ACCORD ENTERPRISES PROFESSIONAL LLC
Entity type:Organization
Organization Name:ACCORD ENTERPRISES PROFESSIONAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PAYER ENROLLMENT MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA-ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:2121 S ONEIDA ST
Mailing Address - Street 2:STE 321
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224
Mailing Address - Country:US
Mailing Address - Phone:303-796-8767
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:STE 321
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224
Practice Address - Country:US
Practice Address - Phone:303-796-8767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62059700Medicaid