Individual provider Active NPI

Bruna F. De Gouveia, DDS

  • General Practice Dentistry
  • Carlsbad, NM
National Provider Identifier
1295324325
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD5505 Issued in NM
Practice address
612 N Canyon St
Carlsbad, NM 88220-5842
Phone
(575) 887-7594
Fax
(575) 887-3962
NPI assigned
Jan 13, 2021
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00204620 CO
Dentist 122300000X DD5505 NM
General Practice Dentistry 1223G0001X DD5505 NM Primary

Addresses

Primary practice location

612 N Canyon St
Carlsbad, NM 88220-5842

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210213000026 CT Order and Referring Only - Other (Non-Physician) 0547675100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00204620COMDDentist
DD5505NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bruna de Gouveia LLC General Practice CurrentSince Mar 30, 2025 Accepting new patients
William T. McCauley D.D.S. General Practice CurrentSince Mar 24, 2025 Accepting new patients

Locations

612 N Canyon St
Carlsbad, NM 88220
Phone (505) 887-7594

Organizations & group practices 2

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1295324325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N CANYON ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882205842",
            "telephone_number": "575-887-7594",
            "fax_number": "575-887-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GOUVEIA",
        "first_name": "BRUNA",
        "middle_name": "F.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204620",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5505",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.