Individual provider Active NPI

Raktim Bir, DDS

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1285024729
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD4679 Issued in NM
Practice address
510 NM 528
Suite I
Albuquerque, NM 87004
Phone
(505) 867-0665
NPI assigned
Feb 4, 2015
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 202437 CO
General Practice Dentistry 1223G0001X DD4679 NM Primary

Addresses

Primary practice location

510 NM 528
Suite I
Albuquerque, NM 87004

Mailing address

510 NM 528
Suite I
Albuquerque, NM 87004
Phone (505) 867-0665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002000010 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3274841747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202437COMDGeneral Practice Dentistry
DD4679NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Perfect Teeth - Candelaria P.C. General Practice Past Accepting new patients
Perfect Teeth - Alice P.C. General Practice PastSince Oct 24, 2021 Accepting new patients
Perfect Teeth / Venada Plaza P.C. General Practice PastSince Jul 23, 2023 Accepting new patients
Mississippi Dental Group P.C. General Practice Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1285024729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NM 528",
            "address_2": "SUITE I",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87004",
            "telephone_number": "505-867-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NM 528",
            "address_2": "SUITE I",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87004",
            "telephone_number": "505-867-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIR",
        "first_name": "RAKTIM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-04",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "202437",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.