NPIMap

Organization Active NPI

New Mexico Professional Dental Associates, Inc

Doing business as Family Dentistry of Cherry Hills

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1164816039
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Doing business as
Family Dentistry of Cherry Hills
Practice address
5700 San Antonio Dr NE
Suite A1
Albuquerque, NM 87109-4128
Phone
(505) 273-5363
NPI assigned
Mar 27, 2015
Last updated
Mar 27, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

5700 San Antonio Dr NE
Suite A1
Albuquerque, NM 87109-4128

Mailing address

5700 San Antonio Dr NE
Suite A1
Albuquerque, NM 87109-4128

Other names 1

  • Family Dentistry of Cherry Hills Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Mexico Professional Dental7 organizations share this tax ID, including this one
Part of
New Mexico Professional Dental

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5700 San Antonio Dr NE
Ste A1
Albuquerque, NM 87109
Phone (505) 273-5363

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1164816039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SAN ANTONIO DR NE",
            "address_2": "SUITE A1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 SAN ANTONIO DR NE",
            "address_2": "SUITE A1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094128",
            "telephone_number": "505-273-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dentistry of Cherry Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 27, 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.