Leo Paul Balderamos, DDS MS

Primary specialty

DentistTaxonomy code 122300000X

License

1828 Issued in NM

Practice address

409 Saint Michaels Drive
Suite D
Santa Fe, NM 87505

Phone

(505) 983-7373

Fax

(505) 989-1552

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508070178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SAINT MICHAELS DRIVE",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-983-7373",
            "fax_number": "505-989-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 SAINT MICHAELS DRIVE",
            "address_2": "SUITE D",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-983-7373",
            "fax_number": "505-989-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAMOS",
        "first_name": "LEO",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "1828",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "16475",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Bajema, MD
• Cordell Baker
• David Michael Baker, D.M.D
• Judith Ann Baker, LISW
• Alexandra Bakos, M.A, ED.D., LED
• Paul Balderamos
• Thomas Spencer Baldinger, MSW
• Devin Baldwin
• Newton Eddie Baldwin, PA-C
• Susan Balkman, LPC, LADAC, CPCC

• Dentist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.