Childrens Dental Clinic of Ruidoso PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DD1984 Issued in NM

Legal business name

CHILDRENS DENTAL CLINIC OF RUIDOSO PC

Practice address

721 Mechem Sierra Mall #5
Ruidoso, NM 88345-6911

Phone

(505) 257-0246

Fax

(505) 257-0249

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mack Allen McGuinness, DDS

Title

President

Phone

(505) 257-0246

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1376618967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 MECHEM SIERRA MALL #5",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456911",
            "telephone_number": "505-257-0246",
            "fax_number": "505-257-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 MECHEM SIERRA MALL #5",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456911",
            "telephone_number": "505-257-0246",
            "fax_number": "505-257-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTAL CLINIC OF RUIDOSO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "MCGUINNESS",
        "authorized_official_first_name": "MACK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-257-0246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NM",
            "license": "DD1984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NM",
            "identifier": "008C53",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71823",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Center of Protective Environment, Inc.
• Sara Leslie Chapman, LSAA
• Angela Louise Chavez, PTA
• Jackie Chavez
• Jaden N Chavez
• Kenneth Childress, DDS
• Charlotte Arlene Christopher, RN
• Terry Rustyn Christopher
• Michael P Clements, M.D.
• Clinical Counseling, Rebekah Stephens LLC

• Dental Clinic/Center in Ruidoso, NM
• Providers in Ruidoso, 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 Sep 5, 2007; 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.