Northern New Mexico Periodontal Assoc.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DD1125 Issued in NM

Legal business name

NORTHERN NEW MEXICO PERIODONTAL ASSOC.

Practice address

318 Grant Ave
Santa Fe, NM 87501-1933

Phone

(505) 988-8822

Fax

(505) 988-8824

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William Dean Parker, D.D.S

Title

President

Phone

(505) 988-8822

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bill Dean Parker, D.D.S.

  • Periodontics
  • Santa Fe, NM
  • NPI 1205026796
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043371842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 GRANT AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011933",
            "telephone_number": "505-988-8822",
            "fax_number": "505-988-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 GRANT AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011933",
            "telephone_number": "505-988-8822",
            "fax_number": "505-988-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN NEW MEXICO PERIODONTAL ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-988-8822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NM",
            "license": "DD1125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Star Behavioral Consulting, LLC
• North Star Counseling, LLC
• Northern Counseling LLC
• Northern New Mexico Hearing and Balance Institute, LLC
• Northern New Mexico Neuropsychology LLC
• Northern New Mexico Podiatry Assoc.
• Northern New Mexico Vascular Lab Inc.
• Northern NM Gastroenterology
• Northern NM Medical Management, LLC
• Frederic W Northern, PA-C

• Periodontics in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Periodontics 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.