Active NPI
Kimberly Ruth Woods, DMD
- Dentist
- New Laguna, NM
National Provider Identifier
1861580276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD2105
- Practice address
- State Rd 124
Laguna Dental Clinic
New Laguna, NM 87038 - Phone
- (505) 552-6645
- NPI assigned
- Oct 11, 2006
- Last updated
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD2105 | NM | Primary |
Addresses
Primary practice location
State Rd 124
Laguna Dental Clinic
New Laguna, NM 87038
Mailing address
PO Box 130
Acl Indian Hosp (IHS) Attn Business Office
San Fidel, NM 87049
Phone (505) 552-6644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H3451 | Medicaid | NM |
Other names 1
- Dr. Kimberly Woods Montoya
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
| License | State | Type | Specialty |
|---|---|---|---|
| DD2105 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acoma Canoncito Laguna Indian | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba DHHS Usphs Indian Health Services
- Ambulance
- San Fidel, NM
- NPI 1649462532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1861580276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"address_2": "ACL INDIAN HOSP (IHS) ATTN BUSINESS OFFICE",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "87049",
"telephone_number": "505-552-6644",
"fax_number": "505-552-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "STATE RD 124",
"address_2": "LAGUNA DENTAL CLINIC",
"city": "NEW LAGUNA",
"state": "NM",
"postal_code": "87038",
"telephone_number": "505-552-6645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "KIMBERLY",
"middle_name": "RUTH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD2105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H3451",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "MONTOYA",
"middle_name": "WOODS",
"prefix": "DR.",
"credential": "DMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in New Laguna, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.