Individual provider Active NPI

Stephen H Christiansen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Albuquerque, NM
National Provider Identifier
1679567242
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DD1889 Issued in NM
Practice address
4801 McMahon Blvd NW
#230
Albuquerque, NM 87114-5090
Phone
(505) 792-4788
Fax
(505) 792-2533
NPI assigned
Sep 9, 2005
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DD1889 NM Primary

Addresses

Primary practice location

4801 McMahon Blvd NW
#230
Albuquerque, NM 87114-5090

Mailing address

4801 McMahon Blvd NW
#230
Albuquerque, NM 87114-5090
Phone (505) 792-4788

Other identifiers 1

IdentifierTypeStateIssuer
Q4365MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 17, 2017 through Jul 17, 2027

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4801 McMahon Blvd NW
Suite 230
Albuquerque, NM 87114-5478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Mesa Oral and Maxillofacial Surgery PC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1679567242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 MCMAHON BLVD NW",
            "address_2": "#230",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145090",
            "telephone_number": "505-792-4788",
            "fax_number": "505-792-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 MCMAHON BLVD NW",
            "address_2": "#230",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145090",
            "telephone_number": "505-792-4788",
            "fax_number": "505-792-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NM",
            "license": "DD1889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q4365",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.