Organization Active NPI

Orthodontic Specialists of Albuquerque Santa Fe

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1639397854
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
DD2277 Issued in NM
Legal business name
ORTHODONTIC SPECIALISTS OF ALBUQUERQUE SANTA FE
Practice address
8216 Louisiana Blvd NE
Albuquerque, NM 87113-2105
Phone
(505) 822-1234
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mitchell B Silverman, DMD
Title
Orthodontist
Phone
(505) 822-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X DD2277 NM Primary

Addresses

Primary practice location

8216 Louisiana Blvd NE
Albuquerque, NM 87113-2105

Mailing address

8216 Louisiana Blvd NE
Albuquerque, NM 87113-2105
Phone (505) 822-1234

Other identifiers 2

IdentifierTypeStateIssuer
179859MedicaidNM
13602MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639397854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8216 LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132105",
            "telephone_number": "505-822-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8216 LOUISIANA BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132105",
            "telephone_number": "505-822-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC SPECIALISTS OF ALBUQUERQUE SANTA FE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SILVERMAN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "505-822-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "DD2277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179859",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13602",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.