NPIMap

Organization Active NPI

Robert C Supple DMD

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1053780759
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1365 Issued in NM
Legal business name
ROBERT C SUPPLE DMD
Practice address
8401 Osuna Rd NE Ste C
Albuquerque, NM 87111-2074
Phone
(505) 294-8869
Fax
(505) 292-2071
NPI assigned
Sep 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Suzy Price
Title
Office Manager
Phone
(505) 294-8869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1365 NM Primary

Addresses

Primary practice location

8401 Osuna Rd NE Ste C
Albuquerque, NM 87111-2074

Mailing address

8401 Osuna Rd NE Ste C
Albuquerque, NM 87111-2074
Phone (505) 294-8869

National Provider Directory

National Provider Directory

Locations

8401 Osuna Rd NE
Ste C
Albuquerque, NM 87111
Phone (505) 294-8869

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1053780759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 OSUNA RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112074",
            "telephone_number": "505-294-8869",
            "fax_number": "505-292-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 OSUNA RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112074",
            "telephone_number": "505-294-8869",
            "fax_number": "505-292-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C SUPPLE DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "SUZY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-294-8869"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.