Individual provider Active NPI

Steven R Fife, DDS

  • General Practice Dentistry
  • Rio Rancho, NM
National Provider Identifier
1063712909
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD2954 Issued in NM
Practice address
2240 Grande Blvd SE Ste 101
Rio Rancho, NM 87124-1655
Phone
(505) 994-1700
NPI assigned
Oct 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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 DD2954 NM Primary
General Practice Dentistry 1223G0001X 45689 CA

Addresses

Primary practice location

2240 Grande Blvd SE Ste 101
Rio Rancho, NM 87124-1655

Mailing address

2240 Grande Blvd SE Ste 101
Rio Rancho, NM 87124-1655
Phone (505) 994-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008002124 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4880902998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45689CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Fife DDS, PC General Practice PastSince Aug 6, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1063712909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 GRANDE BLVD SE STE 101",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241655",
            "telephone_number": "505-994-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GRANDE BLVD SE STE 101",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241655",
            "telephone_number": "505-994-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2954",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.