Bongmin An, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD5580 Issued in NM

Practice address

3211 Coors Blvd SW Ste D2
Albuquerque, NM 87121-5255

Phone

(505) 336-7451

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialty

Dentist

Education

Marquette University School of Dentistry, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Imperium Dental Group LLC

  • Dentist
  • Albuquerque, NM
  • NPI 1518810191
  Medicare reassignment NPD Authorized official
• Access Dental of Triviz LLC

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1972256865
  NPD
• Bridget R. Burris D. D. S., P. C.

  • Dental Clinic/Center
  • Las Cruces, NM
  • NPI 1740662709
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1497960561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6205 CASA BLANCA NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203280",
            "telephone_number": "541-301-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 COORS BLVD SW STE D2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215255",
            "telephone_number": "505-336-7451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10621 Unser Blvd NW Ste G",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871146487",
            "country_code": "US",
            "telephone_number": "505-588-7709",
            "fax_number": "505-212-4119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AN",
        "first_name": "BONGMIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Miguel Amparan, RPH
• Francisco Ampuero, MD
• Bonni Amsden
• Amy Brashear LLC
• Amy Garcia MD, LLC
• Christina VI An, PHARMD
• Ana G Huaman MD LLC
• Anahata Counseling, LLC
• Charlene Analla
• Kelly E. Analla

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.