NPIMap

Organization Active NPI

New Mexico Professional Dental

Doing business as St. Michael's Dental Care

  • Dentist
  • Santa Fe, NM
National Provider Identifier
1073859385
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NEW MEXICO PROFESSIONAL DENTAL
Doing business as
St. Michael's Dental Care
Practice address
444 Saint Michaels Dr
Suite B
Santa Fe, NM 87505-7620
Phone
(217) 540-5100
NPI assigned
Dec 14, 2012
Last updated
Dec 14, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW MEXICO PROFESSIONAL DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Marie Kuhl
Title
Credentialing Manager
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

444 Saint Michaels Dr
Suite B
Santa Fe, NM 87505-7620

Mailing address

444 Saint Michaels Dr
Suite B
Santa Fe, NM 87505-7620
Phone (217) 540-5100

Other names 1

  • St. Michael's Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Mexico Professional Dental7 organizations share this tax ID, including this one
Part of
New Mexico Professional Dental

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1073859385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 SAINT MICHAELS DR",
            "address_2": "SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057620",
            "telephone_number": "217-540-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 SAINT MICHAELS DR",
            "address_2": "SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057620",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO PROFESSIONAL DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW MEXICO PROFESSIONAL DENTAL",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "KUHL",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Michael's Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.