Edmund L Trujillo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD1262 Issued in NM

Practice address

4730 Beckner Road
Santa Fe, NM 87507

Phone

(505) 989-4500

Fax

(505) 443-8313

NPI assigned

Sep 13, 2005

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

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032
  Medicare reassignment NPD
• Presbyterian Medical Services

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1306654462
  NPD
• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1477975688
  NPD
• Las Clinicas del Norte Incorporated

  • Clinic/Center
  • Los Alamos, NM
  • NPI 1194372789
  NPD (past)
• Las Clinicas del Norte, Incorporated

  • Federally Qualified Health Center (FQHC)
  • El Rito, NM
  • NPI 1053314831
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1467447706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 BECKNER ROAD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87507",
            "telephone_number": "505-989-4500",
            "fax_number": "505-443-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 BECKNER ROAD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87507",
            "telephone_number": "505-989-4500",
            "fax_number": "505-443-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUJILLO",
        "first_name": "EDMUND",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD1262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anessa Trujillo, CPSW
• Annale Trujillo
• Cassandra Trujillo
• Chris Trujillo, PTA
• Diana Patricia Trujillo, LISW
• Eleonora Trujillo, PMHNP
• Erica N. Trujillo
• Erin Trujillo
• Isaiah Trujillo, PHARM D.
• Janice Trujillo, LISW

• General Practice Dentistry in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.