Jeremiah M Dye, DDS
Individual provider Active NPI Dentist · Albuquerque, NM
NPI 1376774653 · NPPES record last updated Sep 29, 2021
Key facts
- NPI
- 1376774653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD3184 (NM)
- Practice address
- 2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105-4592 - Phone
- (505) 873-7400
- NPI assigned
- Aug 4, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Owned or controlled facilities with NPI records 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
All facility ownership & control disclosures 7
| Facility | Type | Role | Since |
|---|---|---|---|
| First Choice Community Healthcare |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Feb 25, 2026 Feb 25, 2026 |
| First Choice Community Health |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Aug 5, 2009 Aug 5, 2009 |
| First Choice Community Healthcare, Inc. |
Federally qualified health center | Corporate Officer | Jan 1, 2025 |
| First Choice Community Healthcare, Inc. |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Feb 25, 2026 Feb 25, 2026 |
| First Choice Community Healthcare, Inc. |
Federally qualified health center | Corporate Officer | Jul 24, 2024 |
| First Choice Community Healthcare, Inc. |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Aug 5, 2009 Jun 5, 2023 |
| First Choice Community Healthcare, Inc. |
Federally qualified health center | Corporate Director W-2 Managing Employee |
Jul 24, 2024 Jul 24, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090903000095 | NM | Practitioner - Oral Surgery | 9931254505 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD3184 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Community Healthcare, Inc. | Current | Accepting new patients | |
| First Choice Community Healthcare, Inc. | Current |
Accepting new patients | |
| First Choice Community Healthcare, Inc. | Current |
Accepting new patients |
Locations
2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105
Phone (505) 873-7462
145 Don Pasqual Rd NW
Los Lunas, NM 87031
Phone (505) 224-8740
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD3184 | NM | Yes |
Addresses
Primary practice location
2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105-4592
Mailing address
2001 El Centro Familiar Blvd SW
Albuquerque, NM 87105-4592
Phone (505) 873-7400
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.