Serenity Dental and Spa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SERENITY DENTAL AND SPA

Practice address

441 Wyoming Blvd NE
Albuquerque, NM 87123-1033

Phone

(505) 710-5018

NPI assigned

Oct 14, 2011

Last updated

Oct 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Jenny Xayavong

Title

President

Phone

(505) 710-5018

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1316222938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231033",
            "telephone_number": "505-710-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 WYOMING BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871231033",
            "telephone_number": "505-710-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY DENTAL AND SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "XAYAVONG",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-710-5018",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aleksandr Volk Sergojan, SO-IDC

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.