Modern Dental Professionals New Mexico PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2485 Issued in NM

Legal business name

MODERN DENTAL PROFESSIONALS NEW MEXICO PC

Practice address

8401 Osuna Rd NE
Suite B
Albuquerque, NM 87111-2074

Phone

(505) 332-3544

Fax

(505) 332-4047

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Russell Craig Toler, DDS

Title

Owner

Phone

(505) 332-3544

Specialties & licenses 1

Addresses

Other names 1

• Monarch Dental Doing business as

Locations

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861563082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SANDPOINTE AVE",
            "address_2": "8TH FLOOR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927075778",
            "telephone_number": "505-332-3544",
            "fax_number": "505-332-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 OSUNA RD NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112074",
            "telephone_number": "505-332-3544",
            "fax_number": "505-332-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS NEW MEXICO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOLER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-332-3544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marjorie S Mock, LCSW
• Mod I Solutions LLC
• Amir Modarres, MD
• Modern Alchemist Compounding Pharmacy
• Modern Creations Construction
• Modern Edge Family Practice LLC
• Modern Medicine
• Modern Pain & Spine PC
• Modern Recovery, Inc.
• Modern Surgical Center

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, 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 Aug 22, 2020; 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.