Kendal Trujillo DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

KENDAL TRUJILLO DDS PC

Doing business as

Summit Dental

Practice address

456 Mechem Dr Ste C
Ruidoso, NM 88345-6873

Phone

(575) 257-5179

NPI assigned

Sep 20, 2024

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Sr Credentialing Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Summit Dental Doing business as

Locations

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1083431126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 MECHEM DR STE C",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456873",
            "telephone_number": "575-257-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 MECHEM DR STE C",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456873",
            "telephone_number": "575-257-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDAL TRUJILLO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary L. Jackson, DO
• Rita Jensen
• Alondra Jimenez, COTA
• Juergen Rebstock MD PC
• Anna J Kanseah, BMS
• Kenneth W Childress DDS PC
• Kenneth Kenney
• Daniel Kesler
• Courtney Ann Kessler, PHARMD
• Mark E King, PA

• General Practice Dentistry in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.