Individual provider Active NPI

Yvette Granados, RDH

  • Dental Hygienist
  • Albuquerque, NM
National Provider Identifier
1801259759
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH3061 Issued in NM
Practice address
3520 Montgomery Blvd NE
Albuquerque, NM 87107-4846
Phone
(505) 850-3776
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH3061 NM Primary

Addresses

Primary practice location

3520 Montgomery Blvd NE
Albuquerque, NM 87107-4846

Mailing address

3520 Montgomery Blvd NE
Albuquerque, NM 87107-4846
Phone (505) 850-3776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH3061NMMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1801259759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074846",
            "telephone_number": "505-850-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074846",
            "telephone_number": "505-850-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANADOS",
        "first_name": "YVETTE",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NM",
            "license": "DH3061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.