Individual provider Active NPI

Dominic Lundquist

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1558078196
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-3414
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

1 University of New Mexico
Albuquerque, NM 87131-0001
Phone (505) 272-3414

Other practice location 1

3903 Medical Dr Ste 200
Ogden, UT 84403-2318
Phone (801) 387-5300

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

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1558078196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-3414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3903 Medical Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Ogden",
            "state": "UT",
            "postal_code": "844032318",
            "country_code": "US",
            "telephone_number": "801-387-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "DOMINIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 1, 2026; 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.