Affordable Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2601 Issued in NM

Legal business name

AFFORDABLE DENTAL LLC

Doing business as

Las Cruces Family Dental

Practice address

1423 Don Roser Dr.
Las Cruces, NM 88011-4515

Phone

(575) 541-0072

Fax

(575) 541-1908

NPI assigned

Sep 4, 2008

Last updated

Apr 24, 2012By 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

Mrs. Eileen Ambriz

Title

Practice Manager

Phone

(575) 541-0072

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Las Cruces Family Dental Doing business as

Tax ID family

Affordable Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Affordable Dental

  dba Southwest Family Dental

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1801044938
  NPD tax ID

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.

• Harvey S Reiter, DMD

  • Dentist
  • Las Cruces, NM
  • NPI 1811911142
  NPD (past)

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335225600000",
    "number": "1366690216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 S DON ROSER DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114515",
            "telephone_number": "575-541-0072",
            "fax_number": "575-541-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 DON ROSER DR.",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114515",
            "telephone_number": "575-541-0072",
            "fax_number": "575-541-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2012-04-24",
        "status": "A",
        "authorized_official_last_name": "AMBRIZ",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "575-541-0072",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21223025",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Cruces Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Puja Agarwal
• Agave Dental Bright Star PLLC (Bright Star Dental)

• General Practice Dentistry in Las Cruces, NM
• Providers in Las Cruces, 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 Apr 24, 2012; 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.