NPIMap

Organization Active NPI

Wilson Radiographic Center of Albuquerque, Inc

  • Dental Laboratory
  • Albuquerque, NM
National Provider Identifier
1336297712
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
License
FA0000071 Issued in NM
Legal business name
WILSON RADIOGRAPHIC CENTER OF ALBUQUERQUE, INC
Practice address
3901 Louisiana Blvd NE
Suite E
Albuquerque, NM 87110-1577
Phone
(505) 883-5066
Fax
(505) 888-9466
NPI assigned
Jan 8, 2007
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
Ms. Debra Burns, D.A.
Title
Owner
Phone
(505) 883-5066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X FA0000071 NM Primary

Addresses

Primary practice location

3901 Louisiana Blvd NE
Suite E
Albuquerque, NM 87110-1577

Mailing address

3901 Louisiana Blvd NE
Suite E
Albuquerque, NM 87110-1577
Phone (505) 883-5066

National Provider Directory

National Provider Directory

Locations

3901 Louisiana Blvd NE
Ste E
Albuquerque, NM 87110
Phone (505) 883-5066

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336297712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 LOUISIANA BLVD NE",
            "address_2": "SUITE E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101577",
            "telephone_number": "505-883-5066",
            "fax_number": "505-888-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LOUISIANA BLVD NE",
            "address_2": "SUITE E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101577",
            "telephone_number": "505-883-5066",
            "fax_number": "505-888-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON RADIOGRAPHIC CENTER OF ALBUQUERQUE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-883-5066",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.A."
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "NM",
            "license": "FA0000071",
            "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 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.