NPIMap

Organization Active NPI

Just Clean Smiles, LLC

  • Dental Hygienist
  • Los Lunas, NM
National Provider Identifier
1609176965
Registry record updated Mar 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH-373 Issued in NM
Legal business name
JUST CLEAN SMILES, LLC
Practice address
1204 Main St NE
Suite B
Los Lunas, NM 87031-7409
Phone
(505) 565-0609
Fax
(505) 565-0709
NPI assigned
Nov 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2011

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

Authorized official

Name
Donna M Riordan, RDHNPI 1366741530
Title
Manager/Dental Hygienist
Phone
(505) 565-0609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 1503 NM
Dental HygienistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 124Q00000X DH-373 NM Primary

Addresses

Primary practice location

1204 Main St NE
Suite B
Los Lunas, NM 87031-7409

Mailing address

1204 Main St NE
Suite B
Los Lunas, NM 87031-7409
Phone (505) 565-0609

National Provider Directory

National Provider Directory

Locations

1204 Main St NE
Ste B
Los Lunas, NM 87031
Phone (505) 388-2015

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301184000000",
    "number": "1609176965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST NE",
            "address_2": "SUITE B",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317409",
            "telephone_number": "505-565-0609",
            "fax_number": "505-565-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST NE",
            "address_2": "SUITE B",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317409",
            "telephone_number": "505-565-0609",
            "fax_number": "505-565-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST CLEAN SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2011-03-27",
        "status": "A",
        "authorized_official_last_name": "RIORDAN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER/DENTAL HYGIENIST",
        "authorized_official_telephone_number": "505-565-0609",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "1503",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "NM",
            "license": "DH-373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2011; 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.