Stacey M Reiss, DDS, MDENTSC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DD4909 Issued in NM

Practice address

2800 Coors Blvd NW Ste a
Albuquerque, NM 87120-1204

Phone

(505) 352-1166

NPI assigned

Apr 30, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Albuquerque Modern Dentistry, LLC

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1487953790
  NPD (past)
• Eagle Pointe Dentists and Orthodontics, LLC

  • Dentist
  • Albuquerque, NM
  • NPI 1093053340
  NPD (past)

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1558748434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 EAKES RD NW",
            "city": "LOS RANCHOS",
            "state": "NM",
            "postal_code": "871075538",
            "telephone_number": "203-247-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COORS BLVD NW STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201204",
            "telephone_number": "505-352-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6230 Paseo Del Norte NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871132568",
            "country_code": "US",
            "telephone_number": "505-244-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 Unser Blvd SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871246376",
            "country_code": "US",
            "telephone_number": "505-892-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "470 Highway 528 Ste A",
            "address_purpose": "LOCATION",
            "city": "Bernalillo",
            "state": "NM",
            "postal_code": "870046603",
            "country_code": "US",
            "telephone_number": "505-867-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISS",
        "first_name": "STACEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS, MDENTSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD4909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kierst Reis
• John Heinrich Reiser, LPCC
• Mercedes Reisinger Marshall, PHD
• Dannielle Suzette Reisner
• Andrea Franchesca Reiss, CRNA
• Kimberly J Reiter, MD
• Melonie Dawn Reiter, MOTR/L
• Rebecca Reiter, CNP
• Molly Reitsema, M.D.
• Isabella Reitz-Perez, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.