NPIMap

Organization Active NPI

Main Street Dentistry

  • Dental Clinic/Center
  • Los Lunas, NM
National Provider Identifier
1710052543
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MAIN STREET DENTISTRY
Practice address
705 Main St SW
Los Lunas, NM 87031-8308
Phone
(505) 865-3395
Fax
(505) 865-1414
NPI assigned
Nov 20, 2006
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. Ronald Philip Uilkie, D.D.S.NPI 1639244460
Title
President
Phone
(505) 865-3395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

705 Main St SW
Los Lunas, NM 87031-8308

Mailing address

705 Main St SW
Los Lunas, NM 87031-8308
Phone (505) 865-3395

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710052543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MAIN ST SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318308",
            "telephone_number": "505-865-3395",
            "fax_number": "505-865-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAIN ST SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318308",
            "telephone_number": "505-865-3395",
            "fax_number": "505-865-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UILKIE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-865-3395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, 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.