NPIMap

Organization Active NPI

Unm Medical Group Inc

Doing business as UNM Dental Services - Camino de Salud Ambulatory Surgical Center

  • Dental Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1770879694
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
UNM MEDICAL GROUP INC
Doing business as
UNM Dental Services - Camino de Salud Ambulatory Surgical Center
Practice address
1801 Camino de Salud NE
Suite 1100
Albuquerque, NM 87102-4516
Phone
(505) 925-4301
NPI assigned
Jun 20, 2011
Last updated
Jan 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Authorized official

Name
Gary Cuttrell, D.D.S., J.D.NPI 1720085749
Title
Chief Assistant Professor
Phone
(505) 272-1161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1801 Camino de Salud NE
Suite 1100
Albuquerque, NM 87102-4516

Mailing address

933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3203

Other names 1

  • UNM Dental Services - Camino de Salud Ambulatory Surgical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140211000635 NM Part B Supplier - Ambulatory Surgical Center 4981795267 Practice locations: Albuquerque, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770879694. Details of each certification follow.

Ambulatory surgical center certification: CCN 32C0001122

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
UNM Dental Services-Camino De Salud ASC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
May 31, 2013
Last certification
Mar 15, 2022
Ownership / control type
Non-Profit
Facility address
1801 Camino De Salud NE, Suite 1100
Albuquerque, NM 87102

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2030128Unm Dental Services1801 Camino de Salud NE, Albuquerque, NM 87102Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1801 Camino de Salud NE
Ste 1100
Albuquerque, NM 87102
Phone (505) 925-4301

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1770879694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CAMINO DE SALUD NE",
            "address_2": "SUITE 1100",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024516",
            "telephone_number": "505-925-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNM MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "CUTTRELL",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CHIEF ASSISTANT PROFESSOR",
        "authorized_official_telephone_number": "505-272-1161",
        "authorized_official_credential": "D.D.S., J.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNM Dental Services - Camino de Salud Ambulatory Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.