Individual provider Active NPI

Daniela Rose-Marie Zimmer, D.D.S.

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1467772459
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD2323 Issued in NM
Practice address
10320 Cottonwood Park NW
#D
Albuquerque, NM 87114-7008
Phone
(505) 897-1416
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36240 CA
General Practice Dentistry 1223G0001X DD2323 NM Primary

Addresses

Primary practice location

10320 Cottonwood Park NW
#D
Albuquerque, NM 87114-7008

Mailing address

10320 Cottonwood Park NW
Albuquerque, NM 87114
Phone (505) 897-1416

Other names 1

  • Daniela Rose-Marie Ellison Former name

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

LicenseStateTypeSpecialty
36240CAMDDentist
DD2323NMMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1467772459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 COTTONWOOD PARK NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-897-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 COTTONWOOD PARK NW",
            "address_2": "#D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871147008",
            "telephone_number": "505-897-1416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMER",
        "first_name": "DANIELA",
        "middle_name": "ROSE-MARIE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36240",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELA",
            "last_name": "ELLISON",
            "middle_name": "ROSE-MARIE",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jun 2, 2010; 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.