Blue Sky Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLUE SKY DENTAL LLC

Practice address

10555 Montgomery Blvd NE
Albuquerque, NM 87111-3857

Phone

(505) 275-2492

NPI assigned

Dec 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Corey W Woods, DMDNPI 1861920696

Title

Registered Agent

Phone

(505) 331-2945

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.

• Corey W. Woods

  • Dentist
  • Albuquerque, NM
  • NPI 1861920696
  NPD Authorized official

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1376149971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14005 MESITA CLIFF RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871126517",
            "telephone_number": "505-331-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113857",
            "telephone_number": "505-275-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "505-331-2945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, 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 Dec 9, 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.