Ncdi - Animas Professional, LLP

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8446 Issued in CO

Legal business name

NCDI - ANIMAS PROFESSIONAL, LLP

Practice address

2650 E Pinon Frontage Rd
BLDG #200
Farmington, NM 87402-5084

Phone

(505) 599-9359

NPI assigned

Jun 28, 2016

Organization subpart

No

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

Authorized official

Name

Mark D Crane, D.D.S., M.S.

Title

Managing Partner

Phone

(970) 223-8687

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1104277482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 OAK PARK DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805257348",
            "telephone_number": "970-223-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 E PINON FRONTAGE RD",
            "address_2": "BLDG #200",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025084",
            "telephone_number": "505-599-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NCDI - ANIMAS PROFESSIONAL, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "970-223-8687",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "8446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Farmington, NM
• Providers in Farmington, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.