Triet DO, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD5184 Issued in NM

Practice address

3751 N Main St Ste D
Roswell, NM 88201-0300

Phone

(575) 622-5835

NPI assigned

Jul 23, 2019

Sex

Male

Sole proprietor

No

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.

• Kidskare P.C.

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1316937964
  NPD (past)

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1740833276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 S VALLEY DR STE 300",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053132",
            "telephone_number": "575-532-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 N MAIN ST STE D",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010300",
            "telephone_number": "575-622-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "TRIET",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenifer Diaz
• Tayah Diaz
• Gretta Dickman, LMT
• John Dill
• Lauren Dillard
• Callie M Dodson, CNM
• Crystal Dominguez
• Julianna Dominguez
• Donald E. Wenner M.D. F.a.C.S. P.C.
• Donald J Willis D.O. P.C.

• General Practice Dentistry in Roswell, NM
• Providers in Roswell, 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 23, 2019; 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.