NPIMap

Organization Active NPI

University Family Dental PC

  • Dentist
  • Las Cruces, NM
National Provider Identifier
1396174116
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2317 Issued in NM
Legal business name
UNIVERSITY FAMILY DENTAL PC
Practice address
705 E University Ave Ste B
Las Cruces, NM 88001-5637
Phone
(575) 521-0127
Fax
(575) 647-9533
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Kimberly H Martin, DMDNPI 1649263039
Title
Dentist
Phone
(575) 521-0127

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2317 NM Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2498 NM

Addresses

Primary practice location

705 E University Ave Ste B
Las Cruces, NM 88001-5637

Mailing address

705 E University Ave Ste B
Las Cruces, NM 88001-5637
Phone (575) 521-0127

National Provider Directory

National Provider Directory

Locations

705 E University Ave
Ste B
Las Cruces, NM 88001
Phone (505) 521-0127

Practitioners & affiliated clinicians

Practitioners 3

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": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1396174116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E UNIVERSITY AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015637",
            "telephone_number": "575-521-0127",
            "fax_number": "575-647-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E UNIVERSITY AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880015637",
            "telephone_number": "575-521-0127",
            "fax_number": "575-647-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "575-521-0127",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "2317",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "2498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.