Community Dental Services, Inc.

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

COMMUNITY DENTAL SERVICES, INC.

Practice address

2116 Hinkle St SE
Albuquerque, NM 87102-4930

Phone

(505) 843-7493

Fax

(505) 843-7581

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David A Vargas

Title

Executive Director

Phone

(505) 843-7493

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174632350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 HINKLE ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024930",
            "telephone_number": "505-843-7493",
            "fax_number": "505-843-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 HINKLE ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024930",
            "telephone_number": "505-843-7493",
            "fax_number": "505-843-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-843-7493",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47506",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85831",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87703",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.