NM Center for Cosmetic and Family Dentistry

Primary specialty

SpecialistTaxonomy code 174400000X

License

DD-1867 Issued in NM

Legal business name

NM CENTER FOR COSMETIC AND FAMILY DENTISTRY

Practice address

201 Wyoming Blvd NE
Albuquerque, NM 87123-1029

Phone

(505) 266-5881

Fax

(505) 266-7175

NPI assigned

Jan 11, 2016

Last updated

Jan 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Chon Gardner, DDS

Title

President

Phone

(505) 266-5881

Specialties & licenses 1

Addresses

Other names 1

• Albuquerque Dental Former legal business name

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1023474749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231029",
            "telephone_number": "505-266-5881",
            "fax_number": "505-266-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231029",
            "telephone_number": "505-266-5881",
            "fax_number": "505-266-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NM CENTER FOR COSMETIC AND FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-266-5881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "DD-1867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albuquerque Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joshua Nkemka
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• Charlotte N Nkwenti, CNP
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• Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.