NPIMap

Organization Active NPI

Coronado Family Dental

  • Dental Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1215544432
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CORONADO FAMILY DENTAL
Practice address
11130 Lomas Blvd NE Ste F2
Albuquerque, NM 87112-5581
Phone
(505) 369-6451
NPI assigned
Oct 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Becky Chiem, DDSNPI 1376926006
Title
Dr
Phone
(505) 369-6451

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11130 Lomas Blvd NE Ste F2
Albuquerque, NM 87112-5581

Mailing address

11130 Lomas Blvd NE Ste F2
Albuquerque, NM 87112-5581
Phone (505) 369-6451

National Provider Directory

National Provider Directory

Locations

11130 Lomas Blvd NE
Ste F2
Albuquerque, NM 87112
Phone (505) 369-6451

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": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1215544432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 LOMAS BLVD NE STE F2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125581",
            "telephone_number": "505-369-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 LOMAS BLVD NE STE F2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125581",
            "telephone_number": "505-369-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONADO FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "CHIEM",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "505-369-6451",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Nov 13, 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.