Albuquerque I.H.S. Dental Clinic

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ALBUQUERQUE I.H.S. DENTAL CLINIC

Practice address

9169 Coors Road, NW
Albuquerque, NM 87120

Phone

(505) 346-2306

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Maureen R. Cordova

Title

Chief Executive Officer

Phone

(505) 922-4248

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Good, DDS

  • Dentist
  • Albuquerque, NM
  • NPI 1164438818
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497849186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 67830",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87193",
            "telephone_number": "505-346-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9169 COORS ROAD, NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87120",
            "telephone_number": "505-346-2306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBUQUERQUE I.H.S. DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "505-922-4248",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "846024",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89730",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Albuquerque Health Services
• Albuquerque Health Services LLC (Albuquerque Behavioral Health)
• Albuquerque Health Supplies
• Albuquerque Healthcare for the Homeless
• Albuquerque Heights Healthcare and Rehabilitation Center, LLC (Albuquerque Heights Healthcare and Rehabilitation Center)
• Albuquerque Implant & Periodontal Consultants. LLC
• Albuquerque Indian Center, Inc
• Albuquerque Indian Health Center
• Albuquerque Indian Health Center Pharmacy
• Albuquerque Indian Health Pharmacy

• Dental Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dental Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.