Individual provider Active NPI

Dennis G. Fillmore, D.D.S.

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1639143464
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1278 Issued in NM
Practice address
3901 Louisiana Blvd NE
Albuquerque, NM 87110-1577
Phone
(505) 883-4649
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1278 NM Primary

Addresses

Primary practice location

3901 Louisiana Blvd NE
Albuquerque, NM 87110-1577

Mailing address

3901 Louisiana Blvd NE
Albuquerque, NM 87110-1448
Phone (505) 883-4649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419002271 NM Order and Referring Only - DentistPractitioner - Dentist 0143528463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639143464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101448",
            "telephone_number": "505-883-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101577",
            "telephone_number": "505-883-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "DENNIS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.