New Mexico Center for Craniofacial Pain,LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D664 Issued in NM

Legal business name

NEW MEXICO CENTER FOR CRANIOFACIAL PAIN,LLC

Practice address

7111 Prospect PL NE
Suite D-301
Albuquerque, NM 87110-4309

Phone

(505) 883-6446

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Ben J. Brabb, DDS

Title

Manager

Phone

(505) 883-6446

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396865267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 PROSPECT PL NE",
            "address_2": "SUITE D-301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104309",
            "telephone_number": "505-883-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 PROSPECT PL NE",
            "address_2": "SUITE D-301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104309",
            "telephone_number": "505-883-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO CENTER FOR CRANIOFACIAL PAIN,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRABB",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "505-883-6446",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "D664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Albuquerque, NM
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.