Active NPI
David Dominic Dalise, DDS
- Dentist
- Albuqurque, NM
National Provider Identifier
1467697094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD834
- Practice address
- 8500 Wahington St NE
Ste A1
Albuqurque, NM 87113 - Phone
- (505) 293-0025
- Fax
- (050) 293-0447
- NPI assigned
- Dec 11, 2008
- Last updated
- Dec 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DD834 | NM | Primary |
Addresses
Primary practice location
8500 Wahington St NE
Ste A1
Albuqurque, NM 87113
Mailing address
8500 Wahington St NE
Ste A1
Albuqurque, NM 87113
Phone (505) 293-0025
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 |
|---|---|---|---|
| DD834 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228953600000",
"number": "1467697094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8500 WAHINGTON ST NE",
"address_2": "STE A1",
"city": "ALBUQURQUE",
"state": "NM",
"postal_code": "87113",
"telephone_number": "505-293-0025",
"fax_number": "050-293-0447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8500 WAHINGTON ST NE",
"address_2": "STE A1",
"city": "ALBUQURQUE",
"state": "NM",
"postal_code": "87113",
"telephone_number": "505-293-0025",
"fax_number": "050-293-0447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALISE",
"first_name": "DAVID",
"middle_name": "DOMINIC",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-11",
"last_updated": "2008-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuqurque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.