Active NPI
Sandra Kay Roe, RDH, MS
- Dental Hygienist
- Albuquerque, NM
National Provider Identifier
1417945429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH 917
- Practice address
- 2730 Quincy St NE
Albuquerque, NM 87110-3054 - Phone
- (505) 688-8058
- Fax
- (505) 827-2557
- NPI assigned
- Oct 12, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH 917 | NM | Primary |
Addresses
Primary practice location
2730 Quincy St NE
Albuquerque, NM 87110-3054
Mailing address
2730 Quincy St NE
Albuquerque, NM 87110-3054
Phone (505) 688-8058
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77979826 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH 917 | NM | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417945429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 QUINCY ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871103054",
"telephone_number": "505-688-8058",
"fax_number": "505-827-2557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 QUINCY ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871103054",
"telephone_number": "505-688-8058",
"fax_number": "505-827-2557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROE",
"first_name": "SANDRA",
"middle_name": "KAY",
"credential": "RDH, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NM",
"license": "DH 917",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77979826",
"state": "NM"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.