NPIMap

Organization Active NPI

Pino Periodontics, LLC

  • Periodontics
  • Albuquerque, NM
National Provider Identifier
1316455017
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
PINO PERIODONTICS, LLC
Practice address
7007 Wyoming Blvd NE Ste D1
Albuquerque, NM 87109-3981
Phone
(505) 822-0565
Fax
(505) 821-4242
NPI assigned
Jan 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Authorized official

Name
Rebecca A Pino
Title
Office Manager
Phone
(505) 822-0565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

7007 Wyoming Blvd NE Ste D1
Albuquerque, NM 87109-3981

Mailing address

PO Box 94598
Albuquerque, NM 87199-4598
Phone (505) 822-0565

National Provider Directory

National Provider Directory

Locations

7007 Wyoming Blvd NE
Ste D1
Albuquerque, NM 87109
Phone (505) 822-0565

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1316455017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94598",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871994598",
            "telephone_number": "505-822-0565",
            "fax_number": "505-821-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE D1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093981",
            "telephone_number": "505-822-0565",
            "fax_number": "505-821-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINO PERIODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "PINO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-822-0565"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; 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.