NPIMap

Organization Active NPI

National Orthodontix Management, PLLC

Doing business as SUN Orthodontix of Las Cruces PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Las Cruces, NM
National Provider Identifier
1093767212
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DD2276 Issued in NM
Legal business name
NATIONAL ORTHODONTIX MANAGEMENT, PLLC
Doing business as
SUN Orthodontix of Las Cruces PLLC
Practice address
920 N Telshor Blvd
Suite E
Las Cruces, NM 88011-8244
Phone
(575) 521-0900
Fax
(575) 521-0128
NPI assigned
May 16, 2006
Last updated
Dec 19, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL ORTHODONTIX MANAGEMENT, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Dr. John G. Vondrak, DDSNPI 1730151713
Title
Operating Manager
Phone
(505) 521-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X DD2276 NM Primary

Addresses

Primary practice location

920 N Telshor Blvd
Suite E
Las Cruces, NM 88011-8244

Mailing address

920 N Telshor Blvd
Suite E
Las Cruces, NM 88011-8244
Phone (575) 521-0900

Other identifiers 2

IdentifierTypeStateIssuer
105971MedicaidNM
00785351MedicaidNM

Other names 1

  • SUN Orthodontix of Las Cruces PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
National Orthodontix MGMT LLC5 organizations share this tax ID, including this one
Part of
National Orthodontix MGMT LLC

Other organizations with this tax ID 4

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

Locations

920 N Telshor Blvd
Ste E
Las Cruces, NM 88011
Phone (575) 521-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1093767212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 N TELSHOR BLVD",
            "address_2": "SUITE E",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118244",
            "telephone_number": "575-521-0900",
            "fax_number": "575-521-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 N TELSHOR BLVD",
            "address_2": "SUITE E",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118244",
            "telephone_number": "575-521-0900",
            "fax_number": "575-521-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL ORTHODONTIX MANAGEMENT, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL ORTHODONTIX MANAGEMENT, PLLC",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "VONDRAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OPERATING MANAGER",
        "authorized_official_telephone_number": "505-521-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD2276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105971",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00785351",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUN Orthodontix of Las Cruces PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.