Sundance Technologies and Training Center, LLC

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

61268 Issued in NM

Legal business name

SUNDANCE TECHNOLOGIES AND TRAINING CENTER, LLC

Doing business as

Sundance

Practice address

12300 Menaul Blvd NE
Albuquerque, NM 87112-2557

Phone

(505) 298-6440

Fax

(505) 298-7502

NPI assigned

Jun 20, 2006

Last updated

Aug 22, 2020By 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

Mr. Phillip Lepak, LGC, BA, BS

Title

Director

Phone

(505) 298-6440

Specialties & licenses 1

Addresses

Other names 1

• SUNDANCE Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa E Gillespie, OTR/L

  • Occupational Therapist
  • Albuquerque, NM
  • NPI 1568662138
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033155031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11605",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871920605",
            "telephone_number": "505-298-6440",
            "fax_number": "505-298-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122557",
            "telephone_number": "505-298-6440",
            "fax_number": "505-298-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE TECHNOLOGIES AND TRAINING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEPAK",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-298-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LGC, BA, BS"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NM",
            "license": "61268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNDANCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chun-Xiao Sun, DMD,MS,MSD,PHD
• Gwen Y Sun, MD
• Jerry Sun
• Yijuan Sun, MD
• Suncenter Medical Offices, LLC
• Scott T Sunde, M.D.
• Zoe Sarah Sundell, MD
• Harold B Sunderman, MD
• Jessica Ayesha Rodrigues Sundram
• Sunflower Gardens Homecare

• Other Specialist/Technologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Other Specialist/Technologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.