NPIMap

Organization Active NPI

Professional Dental Care PLLC

  • General Practice Dentistry
  • Santa Fe, NM
National Provider Identifier
1285264242
Registry record updated Jan 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PROFESSIONAL DENTAL CARE PLLC
Practice address
550 Saint Michaels Dr Ste 2
Santa Fe, NM 87505-7604
Phone
(505) 216-2364
NPI assigned
Jan 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2020

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

Authorized official

Name
Dr. Fred Anthony Lacourt, DDS
Title
Chief Dental Officer
Phone
(414) 303-7484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

550 Saint Michaels Dr Ste 2
Santa Fe, NM 87505-7604

Mailing address

10940 S Parker Rd
Parker, CO 80134-7440
Phone (515) 371-3782

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1579305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579305600000",
    "number": "1285264242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10940 S PARKER RD",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347440",
            "telephone_number": "515-371-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SAINT MICHAELS DR STE 2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057604",
            "telephone_number": "505-216-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-18",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A",
        "authorized_official_last_name": "LACOURT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIEF DENTAL OFFICER",
        "authorized_official_telephone_number": "414-303-7484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.