Desoto Dentistry, LLC – General Practice Dentistry

Key facts

NPI: 1417828880
Entity type: Organization (NPI type 2)
Primary specialty: General Practice Dentistry 1223G0001X
Legal business name: DESOTO DENTISTRY, LLC
Practice address: 5925 Wyoming Blvd NE Ste a
Albuquerque, NM 87109-3841
Phone: (505) 269-1818
NPI assigned: Sep 17, 2025
Organization subpart: No

Authorized official

Name: Dr. Brock James Desoto, DDS NPI 1801505607
Title: Dentist
Phone: (505) 269-1818

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Brock J Desoto, DDS General Practice Dentistry · Albuquerque, NM · NPI 1801505607

NPD Authorized official GENERAL PRACTICE

National Provider Directory

Locations

5925 Wyoming Blvd NE
Ste A
Albuquerque, NM 87109
Phone (505) 269-1818

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry Group: 193400000X SINGLE SPECIALTY GROUP	1223G0001X			Yes

Addresses

Primary practice location

5925 Wyoming Blvd NE Ste a
Albuquerque, NM 87109-3841

Mailing address

5925 Wyoming Blvd NE Ste a
Albuquerque, NM 87109-3841
Phone (505) 269-1818

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 23, 2025.

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1417828880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 WYOMING BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093841",
            "telephone_number": "505-269-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 WYOMING BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093841",
            "telephone_number": "505-269-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "DESOTO",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "505-269-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

All providers in Albuquerque, NM · General Practice Dentistry in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.