Portales Dental Arts Center Inc

Primary specialty

DentistTaxonomy code 122300000X

License

DD916 Issued in NM

Legal business name

PORTALES DENTAL ARTS CENTER INC

Practice address

1521 W 18TH St
Portales, NM 88130-7018

Phone

(505) 356-8514

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Buck R Wilson, D.D.S.

Title

President

Phone

(505) 356-8514

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740498179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 W 18TH ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881307018",
            "telephone_number": "505-356-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 W 18TH ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881307018",
            "telephone_number": "505-356-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTALES DENTAL ARTS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BUCK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-356-8514",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathania Pierre
• Monica Rose Romero Plew, P.T.
• Tricia Elizabeth Poindexter
• Cynthia Laviece Polk
• Grace Ponto, PTA
• Portales Health Facilities LP (Loma Linda Nursing and Rehabilitation Center)
• Portales Home Medical Equipment Inc
• Portales Medical Clinic Limited
• Portales Municipal Schools
• Portales Professional Compounding LLC

• Dentist in Portales, NM
• Providers in Portales, NM by specialty
• Dentist in New Mexico

• 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.