Zellisha Alexis Quam, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DD3884 Issued in NM

Practice address

9169 Coors Blvd NW
Albuquerque, NM 87120-3101

Phone

(505) 346-2306

Fax

(505) 346-2311

NPI assigned

Apr 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1770849796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5928 NIGHT SHADOW AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871141975",
            "telephone_number": "505-862-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9169 COORS BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203101",
            "telephone_number": "505-346-2306",
            "fax_number": "505-346-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAM",
        "first_name": "ZELLISHA",
        "middle_name": "ALEXIS",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3884",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NM",
            "license": "DD3884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quad/Med, LLC
• Quality Compassinate Care LLC
• Quality Medical Imaging of New Mexico Inc
• Devona Renee Quam, CHW
• Jennifer Mosier Quam, FNP-BC
• Charles Quane
• Quantum Behavioral Health, LLC
• Francis K Quartey, CRNA
• Molly Quay-de la Vallee
• Armin Quedzuweit, R.PH.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.