Organization Active NPI

Sandia Ridge Dentists, LLC

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1417747403
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SANDIA RIDGE DENTISTS, LLC
Practice address
4800 Cutler Ave NE Ste 25
Albuquerque, NM 87110-4039
Phone
(505) 445-5416
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Authorized official

Name
Jonathan Aragon
Title
Owner
Phone
(714) 845-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4800 Cutler Ave NE Ste 25
Albuquerque, NM 87110-4039

Mailing address

PO Box 660041
Dallas, TX 75266-0041

National Provider Directory

National Provider Directory

Locations

4800 Cutler Ave NE
Ste 25
Albuquerque, NM 87110
Phone (505) 445-5416

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1417747403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 CUTLER AVE NE STE 25",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104039",
            "telephone_number": "505-445-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA RIDGE DENTISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "ARAGON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 May 12, 2025; 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.