DDS Catalyst Country Club LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DDS CATALYST COUNTRY CLUB LLC

Practice address

6588 E. Main St.
Farmington, NM 87402

Phone

(505) 326-6800

Fax

(505) 326-6809

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Andrew Ashby, DDS, MBA

Title

Owner

Phone

(505) 326-6800

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1255445706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6588 E. MAIN ST.",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87402",
            "telephone_number": "505-326-6800",
            "fax_number": "505-326-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6588 E. MAIN ST.",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87402",
            "telephone_number": "505-326-6800",
            "fax_number": "505-326-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDS CATALYST COUNTRY CLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "ASHBY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-326-6800",
        "authorized_official_credential": "DDS, MBA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164051",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Leland Davidson, M.D.
• Beth Lehr Davis, D.C.
• Janice A Davis
• Jo Davis, LISW
• Paul Francis Davis, M.D.
• DDS Catalyst Farmington, LLC
• Atenas De Taboada Da Silva, DMD
• Michele Katherine De' Medici, RN;BSN;M,AC.;LIC.AC.
• Carlene R. Deal-Smith
• Regina Deale

• General Practice Dentistry in Farmington, NM
• Providers in Farmington, 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 Apr 26, 2019; 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.