NPIMap

Organization Active NPI

New Mexico Dentistry Prada, PLLC

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1376215731
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NEW MEXICO DENTISTRY PRADA, PLLC
Practice address
6211 4TH St NW Ste 1
Albuquerque, NM 87107-5700
Phone
(702) 291-2031
Fax
(702) 984-7566
NPI assigned
Oct 4, 2021
Last updated
Oct 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Authorized official

Name
Mrs. April Thacker, MBA
Title
Manager of Payer Relations
Phone
(702) 291-2031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

6211 4TH St NW Ste 1
Albuquerque, NM 87107-5700

Mailing address

2250 S Rancho Dr Ste 205
Las Vegas, NV 89102-4456
Phone (702) 291-2031

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1376215731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 S RANCHO DR STE 205",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891024456",
            "telephone_number": "702-291-2031",
            "fax_number": "702-984-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 4TH ST NW STE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075700",
            "telephone_number": "702-291-2031",
            "fax_number": "702-984-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO DENTISTRY PRADA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "THACKER",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "MANAGER OF PAYER RELATIONS",
        "authorized_official_telephone_number": "702-291-2031",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "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 Oct 4, 2021; 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.