Sunridge Dental Care, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3069 Issued in NM

Legal business name

SUNRIDGE DENTAL CARE, P.C.

Practice address

6400 Central Ave SW
Albuquerque, NM 87105-2033

Phone

(505) 836-0322

NPI assigned

Nov 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Peter Roukema, D.M.D.

Title

President

Phone

(505) 836-0322

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1376844811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 CENTRAL AVE SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871052033",
            "telephone_number": "505-836-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 CENTRAL AVE SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871052033",
            "telephone_number": "505-836-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRIDGE DENTAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "ROUKEMA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-836-0322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.