NPIMap

Organization Active NPI

Bear Canyon Family Dentistry LLC

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1265860936
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD3005 Issued in NM
Legal business name
BEAR CANYON FAMILY DENTISTRY LLC
Practice address
7007 Wyoming Blvd NE Ste B2
Albuquerque, NM 87109-3982
Phone
(505) 821-1430
Fax
(505) 821-1442
NPI assigned
Oct 16, 2013
Last updated
Oct 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Dr. Carissa J Greinel-Blum, DDSNPI 1710137450
Title
Owner
Phone
(505) 821-1430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DD3005 NM Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DD2155 NM
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DD3003 NM

Addresses

Primary practice location

7007 Wyoming Blvd NE Ste B2
Albuquerque, NM 87109-3982

Mailing address

7007 Wyoming Blvd NE Ste B2
Albuquerque, NM 87109-3982
Phone (505) 821-1430

National Provider Directory

National Provider Directory

Locations

7007 Wyoming Blvd NE
Ste B2
Albuquerque, NM 87109
Phone (505) 237-0222

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1265860936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093982",
            "telephone_number": "505-821-1430",
            "fax_number": "505-821-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093982",
            "telephone_number": "505-821-1430",
            "fax_number": "505-821-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CANYON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "GREINEL-BLUM",
        "authorized_official_first_name": "CARISSA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-821-1430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3005",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2155",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.