Organization Active NPI

Rainbow Dental

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1104892884
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2018 Issued in NM
Legal business name
RAINBOW DENTAL
Practice address
8611 Golf Course Rd NW
Albuquerque, NM 87114-5775
Phone
(505) 890-6101
Fax
(505) 890-6102
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Shaun Hwang, MDNPI 1669527560
Title
Owner
Phone
(505) 890-6101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2018 NM Primary

Addresses

Primary practice location

8611 Golf Course Rd NW
Albuquerque, NM 87114-5775

Mailing address

8611 Golf Course Rd NW
Albuquerque, NM 87114-5775
Phone (505) 890-6101

Other identifiers 1

IdentifierTypeStateIssuer
23082MedicaidNM

National Provider Directory

National Provider Directory

Locations

8611 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 890-6101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1104892884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145775",
            "telephone_number": "505-890-6101",
            "fax_number": "505-890-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 GOLF COURSE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145775",
            "telephone_number": "505-890-6101",
            "fax_number": "505-890-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "HWANG",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-890-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "2018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23082",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.