NPIMap

Organization Active NPI

Dr David J Herman's Four Corners Dental, LLC

  • Dentist
  • Farmington, NM
National Provider Identifier
1255753976
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD2459 Issued in NM
Legal business name
DR DAVID J HERMAN'S FOUR CORNERS DENTAL, LLC
Practice address
3751 N Butler Ave
Suite 113
Farmington, NM 87401-6425
Phone
(505) 564-9000
Fax
(505) 564-9100
NPI assigned
Jan 15, 2014
Last updated
Jan 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Kelcey Rightmire
Title
Adminstrative Assistant
Phone
(505) 564-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD2459 NM Primary

Addresses

Primary practice location

3751 N Butler Ave
Suite 113
Farmington, NM 87401-6425

Mailing address

3751 N Butler Ave
Suite 113
Farmington, NM 87401-6425
Phone (505) 564-9000

National Provider Directory

National Provider Directory
Tax ID family
Dr David Herman's Four Corners Dental LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1255753976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 N BUTLER AVE",
            "address_2": "SUITE 113",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016425",
            "telephone_number": "505-564-9000",
            "fax_number": "505-564-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 N BUTLER AVE",
            "address_2": "SUITE 113",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016425",
            "telephone_number": "505-564-9000",
            "fax_number": "505-564-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DAVID J HERMAN'S FOUR CORNERS DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "RIGHTMIRE",
        "authorized_official_first_name": "KELCEY",
        "authorized_official_title_or_position": "ADMINSTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "505-564-9000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.