Active NPI
Robert Festus Belfon, DMD
- Pediatric Dentistry
- Tse Bonito, NM
National Provider Identifier
1164540977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 1860
- Practice address
- 1575 B State Hwy 264
Tse Bonito, NM 87301-3339 - Phone
- (505) 371-5509
- Fax
- (505) 371-5513
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 1860 | NM | Primary |
Addresses
Primary practice location
1575 B State Hwy 264
Tse Bonito, NM 87301-3339
Mailing address
1575 B State Hwy 264
Tse Bonito, NM 87301-3339
Phone (505) 371-5509
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1860 | NM | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric and Special Care Dentistry | Pediatric Dentistry | 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.
-
- Pediatric Dentistry
- Albuquerque, NM
- NPI 1437427929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1164540977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1575 B STATE HWY 264",
"city": "TSE BONITO",
"state": "NM",
"postal_code": "873013339",
"telephone_number": "505-371-5509",
"fax_number": "505-371-5513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 B STATE HWY 264",
"city": "TSE BONITO",
"state": "NM",
"postal_code": "873013339",
"telephone_number": "505-371-5509",
"fax_number": "505-371-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELFON",
"first_name": "ROBERT",
"middle_name": "FESTUS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2020-11-25",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NM",
"license": "1860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tse Bonito, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.