Steven L Wire

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2235 Issued in NM

Practice address

110 Sheep Springs Way
Jemez Pueblo, NM 87024

Phone

(575) 834-7388

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1619058724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ALAMEDA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223750",
            "telephone_number": "505-821-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SHEEP SPRINGS WAY",
            "city": "JEMEZ PUEBLO",
            "state": "NM",
            "postal_code": "87024",
            "telephone_number": "575-834-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRE",
        "first_name": "STEVEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10903585",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1574",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Autumn Trujillo, RN
• Carol Ann Vigil, LMHC
• Brittney Waquie
• Calvin Waquie
• Marylin Jean Watteyne, MSW-LCSW
• Kristyn N Yepa, R.N., B.S.N.

• General Practice Dentistry in Jemez Pueblo, NM
• Providers in Jemez Pueblo, 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 Nov 20, 2009; 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.