Peppermint Dental-Rio Bravo LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PEPPERMINT DENTAL-RIO BRAVO LLC

Practice address

3211 Coors Blvd SW
Suite D-2
Albuquerque, NM 87121-5254

Phone

(972) 869-3789

NPI assigned

Dec 30, 2010

Organization subpart

No

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

Authorized official

Name

Mary Pu

Title

Cfo

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1609170976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 STATE HIGHWAY 161",
            "address_2": "SUITE 198",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392816",
            "telephone_number": "972-869-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 COORS BLVD SW",
            "address_2": "SUITE D-2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215254",
            "telephone_number": "972-869-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPPERMINT DENTAL-RIO BRAVO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-30",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "PU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madhuri Penugonda, M.D.
• Fay Pepin, PA
• William John Peplinski, DOM
• April Pepper
• Peppermint Dental-Montgomery LLC
• Peppermint Dental-San Mateo PLLC
• Sara Pepple, CNTP
• Peptineo LLC
• Anna Peralta, LMHC
• Brieann Peralta

• 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 Dec 30, 2010; 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.