NPIMap

Organization Active NPI

Edgewood Family Dentistry

  • General Practice Dentistry
  • Edgewood, NM
National Provider Identifier
1316917495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
NM1580 Issued in NM
Legal business name
EDGEWOOD FAMILY DENTISTRY
Practice address
1917 Old Highway 66
Edgewood, NM 87015-0000
Phone
(505) 281-0373
Fax
(505) 281-0373
NPI assigned
Jan 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen L Harrington, D.D.S.NPI 1396870861
Title
Owner
Phone
(505) 281-0373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NM1580 NM Primary

Addresses

Primary practice location

1917 Old Highway 66
Edgewood, NM 87015-0000

Mailing address

PO Box 2560
Edgewood, NM 87015-2560
Phone (505) 281-0373

Other identifiers 2

IdentifierTypeStateIssuer
NM1625OtherNMSUE'S NM LISC #
NM1580OtherNMSTEVE'S NM LISC #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316917495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2560",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870152560",
            "telephone_number": "505-281-0373",
            "fax_number": "505-281-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 OLD HIGHWAY 66",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870150000",
            "telephone_number": "505-281-0373",
            "fax_number": "505-281-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-281-0373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "NM1580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUE'S NM LISC #",
            "identifier": "NM1625",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STEVE'S NM LISC #",
            "identifier": "NM1580",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.