Familia Dental Las Cruces LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FAMILIA DENTAL LAS CRUCES LLC

Practice address

1025 El Paseo Rd
Las Cruces, NM 88001-6029

Phone

(888) 988-4066

Fax

(847) 496-7603

NPI assigned

May 18, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Brandon Alexander Taylor, CPCS

Title

Credentialing & Payer Relations MGR

Phone

(847) 453-7396

Specialties & licenses 1

Addresses

Other names 1

• FAMILIA DENTAL Doing business as

Locations

Practitioners 1

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

• Srinivasa Rao Midthana

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1174805642
  NPD (past)

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1144513508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "SUITE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734189",
            "telephone_number": "847-453-7396",
            "fax_number": "847-453-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 EL PASEO RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880016029",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA DENTAL LAS CRUCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CREDENTIALING & PAYER RELATIONS MGR",
        "authorized_official_telephone_number": "847-453-7396",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILIA DENTAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILIA DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Naomi Fahrenkrug
• Kaitlyn Fain
• Kalie Fairclough, NP
• Lorilynn Falin
• Evangelia S Falkner, CNM, PMHNP-BC
• Families & Youth, Inc
• Families and Youth Inc
• Family Pharmacy, LLC
• Family Practice Medical and Dietetic Medical Therapy
• Family Pride Foundation Treatment

• Dental Clinic/Center in Las Cruces, NM
• Providers in Las Cruces, 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 Oct 15, 2021; 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.