Active NPI
Anthony M Nieto, DMD
- General Practice Dentistry
- Albuquerque, NM
National Provider Identifier
1720008469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1626
- Practice address
- 1217 1St St NW
Albuquerque, NM 87102-1529 - Phone
- (505) 766-5197
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 1626 | NM | Primary |
Addresses
Primary practice location
1217 1St St NW
Albuquerque, NM 87102-1529
Mailing address
3401 Comanche Rd NE
Albuquerque, NM 87107-4537
Phone (505) 883-6279
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 |
|---|---|---|---|
| 1626 | NM | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1720008469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 COMANCHE RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871074537",
"telephone_number": "505-883-6279",
"fax_number": "505-872-3909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 1ST ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871021529",
"telephone_number": "505-766-5197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIETO",
"first_name": "ANTHONY",
"middle_name": "M",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "1626",
"primary": true
}
],
"identifiers": [],
"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 Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.