NPIMap

Organization Active NPI

Michael E Roussel DMD PC

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1205215506
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1422 Issued in NM
Legal business name
MICHAEL E ROUSSEL DMD PC
Practice address
7127 Prospect PL NE
Albuquerque, NM 87110-4313
Phone
(505) 881-4365
Fax
(505) 881-8282
NPI assigned
May 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Dr. Michael E Roussel, D.M.D.NPI 1578670774
Title
Owner
Phone
(505) 881-4365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1422 NM Primary
Customized Equipment (DME) 332BC3200X 1422 NM

Addresses

Primary practice location

7127 Prospect PL NE
Albuquerque, NM 87110-4313

Mailing address

7127 Prospect PL NE
Albuquerque, NM 87110-4313
Phone (505) 881-4365

National Provider Directory

National Provider Directory

Locations

7127 Prospect Pl NE
Albuquerque, NM 87110
Phone (505) 881-4365

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1205215506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7127 PROSPECT PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104313",
            "telephone_number": "505-881-4365",
            "fax_number": "505-881-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7127 PROSPECT PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104313",
            "telephone_number": "505-881-4365",
            "fax_number": "505-881-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E ROUSSEL DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "ROUSSEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-881-4365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "1422",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NM",
            "license": "1422",
            "primary": false
        }
    ],
    "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 Jun 30, 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.