Individual provider Active NPI

Gary William Cuttrell, DDS

  • Dental Anesthesiology
  • Albuquerque, NM
National Provider Identifier
1720085749
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
DD2136 Issued in NM
Practice address
1801 Camino de Salud NE
Suite 1100
Albuquerque, NM 87102-4516
Phone
(505) 925-7755
Fax
(505) 925-7800
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-01-9397 OH
Dental Anesthesiology 1223D0004X DD2136 NM Primary
General Practice Dentistry 1223G0001X DD2136 NM

Addresses

Primary practice location

1801 Camino de Salud NE
Suite 1100
Albuquerque, NM 87102-4516

Mailing address

1730 Soplo Rd SE
Albuquerque, NM 87123-4485
Phone (505) 925-7755

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140515001465 NM Practitioner - Oral SurgeryPractitioner - Anesthesiology 0042433260 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD2136NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Feb 20, 2014 Accepting new patients
Unm Medical Group, Inc. CurrentSince Feb 20, 2014 Accepting new patients
Westgate Medical Anesthesia Group Past Accepting new patients
Westgate Pain Management Group, LLC Past Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

1801 Camino de Salud NE
Ste 1100
Albuquerque, NM 87102
Phone (505) 925-7755

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 4

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1720085749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 SOPLO RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871234485",
            "telephone_number": "505-925-7755",
            "fax_number": "505-925-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CAMINO DE SALUD NE",
            "address_2": "SUITE 1100",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024516",
            "telephone_number": "505-925-7755",
            "fax_number": "505-925-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTTRELL",
        "first_name": "GARY",
        "middle_name": "WILLIAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-01-9397",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NM",
            "license": "DD2136",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.