Taos Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3407 Issued in NM

Legal business name

TAOS DENTAL GROUP

Practice address

1392 Weimer Rd
Taos, NM 87571-5307

Phone

(575) 758-8654

Fax

(575) 737-0970

NPI assigned

Feb 12, 2015

Last updated

Feb 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Nylund, DDSNPI 1306178132

Title

Dentist

Phone

(575) 758-8654

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Jack Nylund, D.D.S.

  • General Practice Dentistry
  • Taos, NM
  • NPI 1306178132
  NPD (past) Authorized official

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1609267632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 WEIMER RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715307",
            "telephone_number": "575-758-8654",
            "fax_number": "575-737-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 WEIMER RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875715307",
            "telephone_number": "575-758-8654",
            "fax_number": "575-737-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "NYLUND",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "575-758-8654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3407",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD1078",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taos Addiction Treatment Services
• Taos Chiropractic Health Center, Inc
• Taos Clinic for Children and Youth
• Taos County Arc
• Taos County Dental LLC
• Taos Emergency Group LLC
• Taos Family and Couples Institute
• Taos Family Dentistry, Inc
• Taos Group Home, Inc.
• Taos Health Systems Inc Holy Cross

• General Practice Dentistry in Taos, NM
• Providers in Taos, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.