Individual provider Active NPI

Rebeca Viego

  • General Practice Dentistry
  • Rio Rancho, NM
National Provider Identifier
1053654475
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD5254 Issued in NM
Practice address
2345 Southern Blvd SE Ste B1
Rio Rancho, NM 87124-3761
Phone
(505) 892-0111
NPI assigned
Apr 3, 2013
Last updated
Jun 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20534 FL
General Practice Dentistry 1223G0001X DD5254 NM Primary

Addresses

Primary practice location

2345 Southern Blvd SE Ste B1
Rio Rancho, NM 87124-3761

Mailing address

9100 San Mateo Blvd NE Apt 1124
Albuquerque, NM 87113-2612
Phone (305) 926-3121

Other practice location 1

6230 Paseo Del Norte NE Ste B
Albuquerque, NM 87113-2568
Phone (505) 244-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20534FLMDGeneral Practice Dentistry
DD5254NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tri Dental, LLC General Practice CurrentSince Jan 21, 2022 Accepting new patients
Luis a Sanchez DMD and Associates General Practice Past Accepting new patients
Eagle Pointe Dentists and Orthodontics, LLC Past Accepting new patients
Felix C. Madrid, D.D.S.,P.a. PastSince Jun 21, 2020 Accepting new patients

Locations

2345 Southern Blvd SE
Ste B1
Rio Rancho, NM 87124
Phone (505) 892-0111

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1053654475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 SAN MATEO BLVD NE APT 1124",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132612",
            "telephone_number": "305-926-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 SOUTHERN BLVD SE STE B1",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243761",
            "telephone_number": "505-892-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6230 Paseo Del Norte NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871132568",
            "country_code": "US",
            "telephone_number": "505-244-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIEGO",
        "first_name": "REBECA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20534",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.