Healthcare Provider Details

I. General information

NPI: 1386567626
Provider Name (Legal Business Name): EMBRACE DENTAL CARE CRESTWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 W HIGHWAY 146 STE 2
CRESTWOOD KY
40014-7594
US

IV. Provider business mailing address

6225 W HIGHWAY 146 STE 2
CRESTWOOD KY
40014-7594
US

V. Phone/Fax

Practice location:
  • Phone: 502-515-5005
  • Fax:
Mailing address:
  • Phone: 502-515-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ADERINTO T ADENIRAN
Title or Position: OWNER/ DENTIST
Credential: DMD
Phone: 502-220-1201