Robert C Supple, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1365 Issued in NM

Practice address

8401 Osuna Rd NE
Suite C
Albuquerque, NM 87111-2074

Phone

(505) 294-8869

Fax

(505) 292-2071

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Robert C Supple DMD

  • Dentist
  • Albuquerque, NM
  • NPI 1053780759
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710993100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 OSUNA RD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112074",
            "telephone_number": "505-294-8869",
            "fax_number": "505-292-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 OSUNA RD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112074",
            "telephone_number": "505-294-8869",
            "fax_number": "505-292-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLE",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunstar Creative and Healing Arts
• Super Care, LLC
• Superior Ambulance Service Inc
• Superior Health Care Inc
• Jeffrey J Supple, DMD
• Supporting Hands, LLC
• Samuel Supranovich
• Sikander Surana, M.D.
• Robert John Surawski, M.D.
• Marty Dale Surface, DNP, FNP-BC, ACHPN

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.