Active NPI
Marisol King, DDS
- Dentist
- Albuquerque, NM
National Provider Identifier
1154734762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD4471
- Practice address
- 3400 NM 528 NW
Ste a-107
Albuquerque, NM 87114-7025 - Phone
- (505) 244-1111
- NPI assigned
- Jun 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D008988 | AZ | |
| Dentist | 122300000X | DD4471 | NM | Primary |
Addresses
Primary practice location
3400 NM 528 NW
Ste a-107
Albuquerque, NM 87114-7025
Mailing address
3400 NM 528 NW
Ste a-107
Albuquerque, NM 87114-7025
Phone (505) 244-1111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D008988 | AZ | MD | Dentist |
| DD4471 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cottonwood Smiles Dentistry and Orthodontics, LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Albuquerque, NM
- NPI 1003168022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467331200000",
"number": "1154734762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 NM 528 NW",
"address_2": "STE A-107",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871147025",
"telephone_number": "505-244-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 NM 528 NW",
"address_2": "STE A-107",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871147025",
"telephone_number": "505-244-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MARISOL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-11",
"last_updated": "2016-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D008988",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD4471",
"primary": true
}
],
"identifiers": [],
"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 1, 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.