Active NPI
Ronald Nelson
- General Practice Dentistry
- Kirtland Afb, NM
National Provider Identifier
1467425447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D3164
- Practice address
- 2050A Second Street SE
Kirtland Afb, NM 87117-5522 - Phone
- (505) 846-2607
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D3164 | AZ | Primary |
Addresses
Primary practice location
2050A Second Street SE
Kirtland Afb, NM 87117-5522
Mailing address
2050A Second Street SE
Kirtland Afb, NM 87117-5522
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3164 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1467425447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050A SECOND STREET SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A SECOND STREET SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "505-846-2607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "RONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D3164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.