Active NPI
Gene Alan Gabaldon, DDS
- General Practice Dentistry
- Las Cruces, NM
National Provider Identifier
1679698690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- NM 1704
- Practice address
- 2460 S Locust
Ste C
Las Cruces, NM 88001 - Phone
- (505) 521-0306
- Fax
- (505) 522-1132
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | NM 1704 | NM | Primary |
Addresses
Primary practice location
2460 S Locust
Ste C
Las Cruces, NM 88001
Mailing address
2460 S Locust
Ste C
Las Cruces, NM 88001
Phone (505) 521-0306
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00083655 | Medicaid | NM | |
| 283655 | Medicaid | NM | |
| 3248 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NM 1704 | NM | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679698690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 S LOCUST",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88001",
"telephone_number": "505-521-0306",
"fax_number": "505-522-1132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 S LOCUST",
"address_2": "STE C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88001",
"telephone_number": "505-521-0306",
"fax_number": "505-522-1132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABALDON",
"first_name": "GENE",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "NM 1704",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00083655",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "283655",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3248",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.