Perfect Teeth - Fourth Street P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1398 Issued in NM

Legal business name

PERFECT TEETH - FOURTH STREET P.C.

Doing business as

Perfect Teeth - Fourth Street P.C.

Practice address

5721 4TH St NW
Albuquerque, NM 87107-5302

Phone

(505) 345-0515

Fax

(505) 345-2418

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Laurie Summers

Title

Credentialing

Phone

(303) 285-6098

Specialties & licenses 1

Addresses

Other names 1

• Perfect Teeth - Fourth Street P.C. Doing business as

Locations

Practitioners 4

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

• Shu-Ching Catherine Chang, DMD

  • Dentist
  • Albuquerque, NM
  • NPI 1013014554
  NPD (past)
• Priscilla M Leary, DDS

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1346875978
  NPD (past)
• Barbara V Lewis Heywood, DMD

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1265416069
  NPD (past)
• Elizabeth Ann Vanleeuwen, DDS

  • Dentist
  • Santa Fe, NM
  • NPI 1215014121
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336260769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 4TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075302",
            "telephone_number": "505-345-0515",
            "fax_number": "505-345-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 4TH ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075302",
            "telephone_number": "505-345-0515",
            "fax_number": "505-345-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT TEETH - FOURTH STREET P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "303-285-6098"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perfect Teeth - Fourth Street P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Perfectly Imperfect
• Perfectly Imperfect
• Lena Perger, MD

• 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 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.