Michael Shawn McCormack, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DB-2026-0084 Issued in NM

Practice address

2573 State Highway 522
Questa, NM 87556-0290

Phone

(575) 586-0315

Fax

(505) 443-8353

NPI assigned

Jul 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michael.mccormack.1@11411.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032

  NM

  Medicare reassignment
• Michael S McCormack, DDS, PC

  • General Practice Dentistry
  • Littleton, CO
  • NPI 1497164842

  General Practice

  NPD (past) Authorized official
• Kidskare P.C.

  • General Practice Dentistry
  • Las Cruces, NM
  • NPI 1316937964

  General Practice

  NPD (past)

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1891007225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 STATE HIGHWAY 522",
            "city": "QUESTA",
            "state": "NM",
            "postal_code": "875560290",
            "telephone_number": "575-586-0315",
            "fax_number": "505-443-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2573 STATE HIGHWAY 522",
            "city": "QUESTA",
            "state": "NM",
            "postal_code": "875560290",
            "telephone_number": "575-586-0315",
            "fax_number": "505-443-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DB-2026-0084",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "00201972",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WA",
            "license": "DE61574138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Haugen, MA
• Suzanne Kiermont
• Audrey Laws, CNP
• Kyline M Martinez, BSN,RN
• Natasha Lee McCants, LCSW
• Angelica Deidre Medina, CCSW
• Druanne Payne, SLP
• Veronika Anne Peacetree, LPCC
• Valerie Lynne Pierce, M.S.W.
• Presbyterian Medical Services

• General Practice Dentistry in Questa, NM
• Providers in Questa, 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 Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.