Individual provider Active NPI

Jesse Varoz, DDS

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1396127619
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4315 Issued in NM
Practice address
10409 Montgomery Pkwy NE
Suite 201
Albuquerque, NM 87111-3852
Phone
(505) 298-7479
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4315 NM Primary

Addresses

Primary practice location

10409 Montgomery Pkwy NE
Suite 201
Albuquerque, NM 87111-3852

Mailing address

10409 Montgomery Pkwy NE
Suite 201
Albuquerque, NM 87111-3852
Phone (505) 298-7479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725002017 NM Order and Referring Only - DentistPractitioner - Dentist 9032402359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Dental NM LLC PastSince Nov 12, 2023 Accepting new patients
Michael D Haight DDS PC PastSince Jun 21, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1396127619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10409 MONTGOMERY PKWY NE",
            "address_2": "SUITE 201",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113852",
            "telephone_number": "505-298-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10409 MONTGOMERY PKWY NE",
            "address_2": "SUITE 201",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113852",
            "telephone_number": "505-298-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAROZ",
        "first_name": "JESSE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.