Danen Sjostrom, DDS, PHD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DD3647 Issued in NM

Practice address

7007 Wyoming Blvd NE
Suite C-2
Albuquerque, NM 87109-3987

Phone

(614) 949-9685

NPI assigned

Jun 16, 2010

Last updated

Nov 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dsjostrom11129@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sandia Pediatric Dentistry

  • Pediatric Dentistry
  • Albuquerque, NM
  • NPI 1497008312
  NPD (past) Authorized official

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1427379130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE",
            "address_2": "SUITE C-2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093987",
            "telephone_number": "614-949-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE",
            "address_2": "SUITE C-2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093987",
            "telephone_number": "614-949-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SJOSTROM",
        "first_name": "DANEN",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD3647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Robert Sitko, M.D.
• Kit Sitterley, DO
• Gerry Situ, PA-C
• Sizewise Rentals
• Michael Charles Sjoquist, MD
• SJT Pediatric Dentistry LLC (ABQ Pediatric Dentistry)
• Anthony Skaff
• Jade Skaggs
• Judith Ann Skala, PH.D.
• Sara E Skarbek-Borowska, MD

• Pediatric Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatric Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.