Individual provider Active NPI

John David Noyes Jr., DDS

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1528086188
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD2523 Issued in NM
Practice address
120 98TH St NW Ste C3
Albuquerque, NM 87121-9021
Phone
(510) 701-5076
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD2523 NM Primary

Addresses

Primary practice location

120 98TH St NW Ste C3
Albuquerque, NM 87121-9021

Mailing address

120 98TH St NW Ste C3
Albuquerque, NM 87121-9021
Phone (505) 352-5439

Other identifiers 2

IdentifierTypeStateIssuer
51004844MedicaidNM
1768244OtherNMUNITED CONCORDIA GROUP #

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160812000759 NM Order and Referring Only - DentistPractitioner - Dentist 4385938489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD2523NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Kid'S Choice Dental, Inc Current Accepting new patients
Kid'S Choice Dental, Inc Current Accepting new patients

Locations

120 98th St NW
Ste C3
Albuquerque, NM 87121
Phone (505) 352-5439

6211 4th St NW
Ste 13
Albuquerque, NM 87107
Phone (505) 634-5541

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1528086188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 98TH ST NW STE C3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871219021",
            "telephone_number": "505-352-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 98TH ST NW STE C3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871219021",
            "telephone_number": "510-701-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOYES",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51004844",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA GROUP #",
            "identifier": "1768244",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.