Michael Ross Conner, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD4332 Issued in NM

Practice address

2800 Coors Blvd NW
A
Albuquerque, NM 87120-1204

Phone

(505) 352-1166

Fax

(505) 352-2805

NPI assigned

Sep 16, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CRDS

  • Dentist
  • Albuquerque, NM
  • NPI 1013390087
  NPD (past) Authorized official
• Albuquerque Modern Dentistry, LLC

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1487953790
  NPD (past)

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1225407604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 RICHMOND DR SE UNIT 206",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062252",
            "telephone_number": "575-642-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COORS BLVD NW",
            "address_2": "A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201204",
            "telephone_number": "505-352-1166",
            "fax_number": "505-352-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Conneely, MD
• Mikayla Crista Conneen
• Owen Patrick Connelly Vaquer
• Elizabeth Anne Connelly, M.D.
• George J Conner
• Scott Dean Conner, MMFT, LMFT
• Todd Allen Conner, PHARM.D.
• Veronica Conner
• Cherrish Connick
• Sky B Connolly, MD

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.