Mark Edward Urbane, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1681 Issued in NM

Practice address

5820 Menaul Blvd NE
Albuquerque, NM 87110-3238

Phone

(505) 884-6408

Fax

(505) 872-3065

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215056551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103238",
            "telephone_number": "505-884-6408",
            "fax_number": "505-872-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103238",
            "telephone_number": "505-884-6408",
            "fax_number": "505-872-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBANE",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80309",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uptown Park Dental Practice, LLC
• Upward Motion, LLC
• Jennifer A Urban, LPCC
• Samantha Coleman Urban
• Suzette Urban, CPSW/CCSS
• Audrey Urbano, MD
• James Urbany, LCSW
• Clarissa Urbina
• Jennifer Urbina, PA-C
• Kristina Urbizo

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.