NPIMap

Organization Active NPI

New Mexico Professional Dental Associates, Inc

Doing business as Family Dental

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1326766155
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC
Doing business as
Family Dental
Practice address
8400 Osuna Rd NE Ste 4a
Albuquerque, NM 87111-2071
Phone
(505) 294-4700
NPI assigned
Aug 18, 2022
Organization subpart
Yes
Parent organization
NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

8400 Osuna Rd NE Ste 4a
Albuquerque, NM 87111-2071

Mailing address

8400 Osuna Rd NE Ste 4a
Albuquerque, NM 87111-2071

Other names 1

  • Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Mexico Professional Dental7 organizations share this tax ID, including this one
Part of
New Mexico Professional Dental

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8400 Osuna Rd NE
Ste 4A
Albuquerque, NM 87111
Phone (505) 294-4700

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": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1326766155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 OSUNA RD NE STE 4A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 OSUNA RD NE STE 4A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112071",
            "telephone_number": "505-294-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW MEXICO PROFESSIONAL DENTAL ASSOCIATES, INC",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 18, 2022; 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.