Endodontic Associates, L.L.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2728 Issued in NM

Legal business name

ENDODONTIC ASSOCIATES, L.L.C.

Practice address

7520 Montgomery Blvd NE
Building C Suite B
Albuquerque, NM 87109-1521

Phone

(505) 881-6902

Fax

(505) 881-7496

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terryl Ann Petropoulos, D.M.D.

Title

Member

Phone

(505) 881-6902

Specialties & licenses 1

Addresses

Other names 1

• Endodontic Associates, L.L.C. Former legal business name

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104942275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 MONTGOMERY BLVD NE",
            "address_2": "BUILDING C, SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091521",
            "telephone_number": "505-881-6902",
            "fax_number": "505-881-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 MONTGOMERY BLVD NE",
            "address_2": "BUILDING C SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091521",
            "telephone_number": "505-881-6902",
            "fax_number": "505-881-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETROPOULOS",
        "authorized_official_first_name": "TERRYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "505-881-6902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NM",
            "license": "2728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endodontic Associates, L.L.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dental Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dental Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.