Uptown Park Dental Practice, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

UPTOWN PARK DENTAL PRACTICE, LLC

Practice address

2100 Louisiana Blvd NE
Suite 104
Albuquerque, NM 87110-5419

Phone

(505) 883-4867

Fax

(505) 883-4007

NPI assigned

May 8, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Steven Maxey

Title

Business Manager

Phone

(303) 789-5224

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jordan Ghiassi, DMD

  • Periodontics
  • Santa Fe, NM
  • NPI 1053795112
  NPD (past)

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1447427513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LOUISIANA BLVD NE",
            "address_2": "SUITE 104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105419",
            "telephone_number": "505-883-4867",
            "fax_number": "505-883-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 LOUISIANA BLVD NE",
            "address_2": "SUITE 104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105419",
            "telephone_number": "505-883-4867",
            "fax_number": "505-883-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN PARK DENTAL PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "MAXEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "303-789-5224",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORIDA",
            "identifier": "0973127",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dona Jean Upson, MD
• Upstream ABA New Mexico LLC
• Uptown Dental Associates
• Uptown Dermatology LLC
• Uptown Eye Care LLC
• Upward Motion, LLC
• Jennifer A Urban, LPCC
• Samantha Coleman Urban
• Suzette Urban, CPSW/CCSS
• Mark Edward Urbane, DDS

• Dental Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dental Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.