NPIMap

Organization Active NPI

Sandia Heights Dental Care, LLC

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1376816983
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD3442 Issued in NM
Legal business name
SANDIA HEIGHTS DENTAL CARE, LLC
Practice address
12241 Academy Rd NE
Suite 203
Albuquerque, NM 87111-8051
Phone
(505) 332-8025
Fax
(505) 332-8438
NPI assigned
Feb 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Monique LeeNPI 1134120769
Title
Owner/Dentist
Phone
(505) 332-8025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DD3442 NM Primary

Addresses

Primary practice location

12241 Academy Rd NE
Suite 203
Albuquerque, NM 87111-8051

Mailing address

12241 Academy Rd NE
Suite 203
Albuquerque, NM 87111-8051
Phone (505) 332-8025

National Provider Directory

National Provider Directory

Locations

12241 Academy Rd NE
Ste 203
Albuquerque, NM 87111
Phone (505) 332-8025

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1376816983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12241 ACADEMY RD NE",
            "address_2": "SUITE 203",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118051",
            "telephone_number": "505-332-8025",
            "fax_number": "505-332-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12241 ACADEMY RD NE",
            "address_2": "SUITE 203",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118051",
            "telephone_number": "505-332-8025",
            "fax_number": "505-332-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA HEIGHTS DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "505-332-8025"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3442",
            "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 Feb 13, 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.