Trucare Dental Wyoming Blvd LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DD3577 Issued in NM

Legal business name

TRUCARE DENTAL WYOMING BLVD LLC

Practice address

1510 Wyoming Blvd NE Ste a
Albuquerque, NM 87112-3866

Phone

(505) 369-0074

NPI assigned

Oct 8, 2015

Organization subpart

No

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

Authorized official

Name

Andrea Patterson, DDS

Title

President

Phone

(505) 369-0074

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1134590722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 WYOMING BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123866",
            "telephone_number": "505-369-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 WYOMING BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123866",
            "telephone_number": "505-369-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUCARE DENTAL WYOMING BLVD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-369-0074",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57279047",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Trout, M.S., CCC-SLP
• Cathrine Troy, MA, LPCC, LPAT ATR
• Maribeth Troyer, FNP-C
• Tru-Quality Design/Construction Inc.
• Trucare Dental Group
• Trucare Mobile
• Elizabeth Truchon
• Michelle Truckey, D.O.M, L.AC.
• True Color Counseling
• True Color Counseling, LLC

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.