NPIMap

Organization Active NPI

CDB Rio Bravo LLC

  • Dental Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1447500384
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DD3662 Issued in NM
Legal business name
CDB RIO BRAVO LLC
Practice address
1625 Rio Bravo Blvd SW
Albuquerque, NM 87105-6057
Phone
(505) 850-0305
NPI assigned
Sep 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Authorized official

Name
Dr. Jonah FoutzNPI 1437411493
Title
DDS
Phone
(505) 850-0305

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DD3662 NM Primary

Addresses

Primary practice location

1625 Rio Bravo Blvd SW
Albuquerque, NM 87105-6057

Mailing address

7120 Calle Alegria NE
Albuquerque, NM 87113-1368

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1447500384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 CALLE ALEGRIA NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 RIO BRAVO BLVD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871056057",
            "telephone_number": "505-850-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDB RIO BRAVO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "FOUTZ",
        "authorized_official_first_name": "JONAH",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "505-850-0305",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NM",
            "license": "DD3662",
            "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 Sep 19, 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.