Angel Fire Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ANGEL FIRE DENTAL CORP

Practice address

27479 Hwy 64
Angel Fire, NM 87710

Phone

(575) 214-4369

NPI assigned

Jul 2, 2019

Last updated

Jul 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Doolin, DMDNPI 1598323990

Title

President

Phone

(575) 214-4369

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Timothy Doolin, DMD

  • Dentist
  • Angel Fire, NM
  • NPI 1598323990
  NPD (past) Authorized official

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1346802188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1953",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875711953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27479 HWY 64",
            "city": "ANGEL FIRE",
            "state": "NM",
            "postal_code": "87710",
            "telephone_number": "575-214-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL FIRE DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "DOOLIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-214-4369",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Fire Family Dentistry PC
• Angel Fire Primary Care
• Bestcare Pharmacy Angel Fire LLC
• Marc Comtois, LCSW
• Kyle Deisig, FNP-C

• Dental Clinic/Center in Angel Fire, NM
• Providers in Angel Fire, NM by specialty
• Dental Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.