Santa Fe Community College Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SANTA FE COMMUNITY COLLEGE DENTAL CLINIC

Practice address

6401 S Richards Ave
Santa Fe, NM 87508-4887

Phone

(505) 428-1710

Fax

(505) 428-1511

NPI assigned

Feb 15, 2008

Organization subpart

No

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

Authorized official

Name

Alfred Otero, DDS

Title

Dentist

Phone

(505) 428-1710

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1790953404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 S RICHARDS AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875084887",
            "telephone_number": "505-428-1710",
            "fax_number": "505-428-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 S RICHARDS AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875084887",
            "telephone_number": "505-428-1710",
            "fax_number": "505-428-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA FE COMMUNITY COLLEGE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "OTERO",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "505-428-1710",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68727",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Santa Fe Bliss, LLC
• Santa Fe Bodywork, LLC
• Santa Fe Cardiology PC
• Santa Fe Caregiving Company LLC (CareCo - The Caregiving Company)
• Santa Fe Children's Dentistry
• Santa Fe Community Guidance Center
• Santa Fe County
• Santa Fe Dentist Office, LLC (Santa Fe Dentist Office)
• Santa Fe Derm and Wellness
• Santa Fe Dialectical Behavior Therapy, LLC

• General Practice Dentistry in Santa Fe, NM
• Providers in Santa Fe, 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 Feb 15, 2008; 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.