Individual provider Active NPI

Hunter Lee Mortley, D.D.S.

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1003905324
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1489 Issued in NM
Practice address
7510 Montgomery Blvd NE
#206
Albuquerque, NM 87109-1500
Phone
(505) 881-1998
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1489 NM Primary

Addresses

Primary practice location

7510 Montgomery Blvd NE
#206
Albuquerque, NM 87109-1500

Mailing address

7510 Montgomery Blvd NE
#206
Albuquerque, NM 87109-1500
Phone (505) 881-1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307000798 NM Order and Referring Only - DentistPractitioner - Dentist 1759687445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1489NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003905324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7510 MONTGOMERY BLVD NE",
            "address_2": "#206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091500",
            "telephone_number": "505-881-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7510 MONTGOMERY BLVD NE",
            "address_2": "#206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091500",
            "telephone_number": "505-881-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTLEY",
        "first_name": "HUNTER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.