Socorro Dental Care Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOCORRO DENTAL CARE INC.

Practice address

1594 Sara Rd SE Ste C
Rio Rancho, NM 87124-1860

Phone

(877) 989-7413

Fax

(505) 226-9697

NPI assigned

Sep 9, 2018

Organization subpart

No

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

Authorized official

Name

George Hanna

Title

Owner

Phone

(505) 273-3220

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• uSmile Dental LLC Doing business as

Tax ID family

New Mexico Dental Clinics 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.

• New Mexico Dental Clinics LLC

  • Customized Equipment (DME)
  • Rio Rancho, NM
  • NPI 1013404581
  NPD tax ID

Locations

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

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1255814968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 SARA RD SE STE C",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241860",
            "telephone_number": "505-273-3220",
            "fax_number": "505-226-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 SARA RD SE STE C",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241860",
            "telephone_number": "877-989-7413",
            "fax_number": "505-226-9697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 Barbara Loop SE",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871241000",
            "country_code": "US",
            "telephone_number": "877-989-7413",
            "fax_number": "505-226-9697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOCORRO DENTAL CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-09",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-273-3220"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DD4651",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90288840",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "uSmile Dental LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "uSmile Dental LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paula E Smith, FNP-C
• Shane Smith, MT22009
• Smiths Food & Drug Centers Inc
• Kendra A Snearly, P.T.
• Jeffrey Tyra Snyder, DMD
• Ariana Rose Solaequi
• Mahdis Solhjoo, MD
• Amy Louise Sollars, NP
• Daniel Richard Soriano
• Isaiah Joseph Sorrell

• All providers in Rio Rancho, NM
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.