Neon Kids Dental of Farmington

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

NEON KIDS DENTAL OF FARMINGTON

Practice address

4760 N Butler Ave Ste C
Farmington, NM 87401-0816

Phone

(505) 592-0482

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By 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

Amanda Salazar

Title

Billing

Phone

(505) 592-0482

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1255076667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 N BUTLER AVE STE C",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010816",
            "telephone_number": "505-592-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEON KIDS DENTAL OF FARMINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "505-592-0482"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Farmington, NM
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.