NPIMap

Individual provider Active NPI

Michael Darais

  • Dentist
  • Kirtland, NM
National Provider Identifier
1730596024
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4137 Issued in NM
Practice address
3 County Road 6523
Kirtland, NM 87417-9452
Phone
(505) 598-6800
NPI assigned
Jul 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4137 NM Primary

Addresses

Primary practice location

3 County Road 6523
Kirtland, NM 87417-9452

Mailing address

4101 Vista Pinon Dr
Farmington, NM 87401-8619
Phone (801) 318-8615

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

LicenseStateTypeSpecialty
DD4137NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Darais Dental Current Accepting new patients
Darais Dental Dentist Current Accepting new patients
Summit Family Dental of Kirtland, LLC Past Accepting new patients

Locations

2124 Freedom Rd
Trinidad, CO 81082
Phone (719) 422-5696

Organizations & group practices 3

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": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1730596024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 VISTA PINON DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018619",
            "telephone_number": "801-318-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COUNTY ROAD 6523",
            "city": "KIRTLAND",
            "state": "NM",
            "postal_code": "874179452",
            "telephone_number": "505-598-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARAIS",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirtland, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.