NPIMap

Organization Active NPI

Bear Canyon Oral & Facial Surgery

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1871922807
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
DD3881 Issued in NM
Legal business name
BEAR CANYON ORAL & FACIAL SURGERY
Practice address
10151 Montgomery NE Ste 2-D
Albuquerque, NM 87111
Phone
(505) 292-3400
Fax
(505) 292-7124
NPI assigned
Nov 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Authorized official

Name
Dr. Travis Charles Rudd, DDSNPI 1255579264
Title
President
Phone
(505) 292-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X DD3881 NM Primary

Addresses

Primary practice location

10151 Montgomery NE Ste 2-D
Albuquerque, NM 87111

Mailing address

10151 Montgomery NE Ste 2-D
Albuquerque, NM 87111
Phone (505) 292-3400

National Provider Directory

National Provider Directory

Locations

10151 Montgomery Blvd NE
Ste 2D
Albuquerque, NM 87111
Phone (505) 292-3400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1871922807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY NE STE 2-D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-292-3400",
            "fax_number": "505-292-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 MONTGOMERY NE STE 2-D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-292-3400",
            "fax_number": "505-292-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR CANYON ORAL & FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-292-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NM",
            "license": "DD3881",
            "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 Nov 12, 2013; 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.