Rio Rancho Oral and Maxillofacial Surgery PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DD1538 Issued in NM

Legal business name

RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC

Practice address

1316 Jackie Road SE
Suite 600
Rio Rancho, NM 87124-6606

Phone

(505) 994-4772

Fax

(505) 994-1925

NPI assigned

Dec 10, 2010

Last updated

Nov 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laurence J Rogel, DDS

Title

President

Phone

(505) 994-4772

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1245533439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 45895",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871745895",
            "telephone_number": "505-994-4772",
            "fax_number": "505-994-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE ROAD SE",
            "address_2": "SUITE 600",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246606",
            "telephone_number": "505-994-4772",
            "fax_number": "505-994-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO RANCHO ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "ROGEL",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-994-4772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DD1538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00085266",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rio Rancho Family Counseling Center, LLC
• Rio Rancho Medical & Infusion Care LLC
• Rio Rancho Mid-High
• Rio Rancho Modern Dentistry, LLC (Rio Rancho Modern Dentistry)
• Rio Rancho Operations, LLC
• Rio Rancho Physical Therapy
• Rio Rancho Public Schools
• Rio Rancho Public Schools
• Rio Rancho Public Schools
• Rio Rancho Smiles

• Oral and Maxillofacial Surgery Clinic/Center in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Oral and Maxillofacial Surgery Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.