Gary Odasso, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2618 Issued in NM

Practice address

6349 US Highway 550
Presbyterian Medical Services
Cuba, NM 87013-0000

Phone

(575) 289-3291

NPI assigned

May 4, 2006

Last updated

May 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• CO HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Espanola, NM
  • NPI 1780689034
  Medicare reassignment NPD
• El Centro Family Health

  • Federally Qualified Health Center (FQHC)
  • Wagon Mound, NM
  • NPI 1538324223
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1023066933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6349 US HIGHWAY 550",
            "address_2": "PRESBYTERIAN MEDICAL SERVICES",
            "city": "CUBA",
            "state": "NM",
            "postal_code": "870130000",
            "telephone_number": "575-289-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6349 US HIGHWAY 550",
            "address_2": "PRESBYTERIAN MEDICAL SERVICES",
            "city": "CUBA",
            "state": "NM",
            "postal_code": "870130000",
            "telephone_number": "575-289-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODASSO",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Lande Kozoll, M.D., M.P.H.
• Hilma M Lewis, CFNP APRN
• Mark Nienhuis, P.A.
• Suzanne Elaine Norman, D.O.
• Lille K. Norstad, P.T.
• Karen Ojeda, DMD
• Julie Marie Pederson, RN
• Chad Sinclair Pfeiffer, LPCC
• Presbyterian Medical Services (Cuba Health Center Pharmacy)
• Presbyterian Medical Services (Cuba Health Center Pharmacy)

• General Practice Dentistry in Cuba, NM
• Providers in Cuba, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.