Individual provider Active NPI

Nazario N. Young-Trujillo, D.D.S.

  • General Practice Dentistry
  • Rio Rancho, NM
National Provider Identifier
1073695961
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD2754 Issued in NM
Practice address
312 Unser Blvd SE
Rio Rancho, NM 87124-2472
Phone
(505) 796-6880
NPI assigned
Oct 19, 2006
Last updated
Dec 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD2754 NM Primary

Addresses

Primary practice location

312 Unser Blvd SE
Rio Rancho, NM 87124-2472

Mailing address

4231 Talmadge Ave NW
Albuquerque, NM 87114-5546
Phone (505) 681-8004

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
DD2754NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nazario N. Young-Trujillo, DDS, Inc General Practice Past 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, 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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1073695961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 TALMADGE AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145546",
            "telephone_number": "505-681-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 UNSER BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242472",
            "telephone_number": "505-796-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-TRUJILLO",
        "first_name": "NAZARIO",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2754",
            "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 Dec 8, 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.