NPIMap

Organization Active NPI

Dental Associates PA

  • General Practice Dentistry
  • Las Cruces, NM
National Provider Identifier
1750484853
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
NM2258 Issued in NM
Legal business name
DENTAL ASSOCIATES PA
Practice address
2205 S Solano Dr
Las Cruces, NM 88001
Phone
(505) 522-7320
Fax
(505) 522-6395
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Authorized official

Name
Dr. David A. Sudimack, D.D.S.NPI 1497883490
Title
President
Phone
(575) 522-7320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X NM1518 NM
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X NM2258 NM Primary

Addresses

Primary practice location

2205 S Solano Dr
Las Cruces, NM 88001

Mailing address

2205 S Solano Dr
Las Cruces, NM 88001
Phone (505) 522-7320

Other identifiers 2

IdentifierTypeStateIssuer
8403OtherNMBLUE CROSS BLUE SHIELD
806920OtherUNITED CONCORDIA INS

Other names 1

  • Dental Associates PA Other name

National Provider Directory

National Provider Directory

Locations

2205 S Solano Dr
Las Cruces, NM 88001
Phone (505) 522-7320

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1750484853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 S SOLANO DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88001",
            "telephone_number": "505-522-7320",
            "fax_number": "505-522-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 S SOLANO DR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88001",
            "telephone_number": "505-522-7320",
            "fax_number": "505-522-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "SUDIMACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-522-7320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "NM1518",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "NM2258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8403",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "806920",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Associates PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.