C. Ross Long, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2057 Issued in NM

Practice address

3740 Coors Blvd NW Ste a
Albuquerque, NM 87120-4762

Phone

(505) 836-1280

Fax

(505) 839-4782

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• North Coors Dental

  • Dentist
  • Albuquerque, NM
  • NPI 1215952189
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306865647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204762",
            "telephone_number": "505-836-1280",
            "fax_number": "505-839-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871204762",
            "telephone_number": "505-836-1280",
            "fax_number": "505-839-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "C. ROSS",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "2057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Long-Daly, OTR/L
• Amber Elizabeth Long-Kilman
• Abigail Long
• Ashley M Long, NP
• Brian Long
• Christine Long
• Denise Michelle Long, LMSW
• Erin M Long, DC
• Joseph Michael Long, M.D.
• Kenny Long

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.