Mark Dyar Brum, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DD1457 Issued in NM

Practice address

2001 N Centro Familiar SW
Albuquerque, NM 87105

Phone

(505) 873-7423

NPI assigned

Nov 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1902993132
  Medicare reassignment NPD
• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1205097490
  NPD
• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1447412796
  NPD

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1902888340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N CENTRO FAMILIAR SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87105",
            "telephone_number": "505-873-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N CENTRO FAMILIAR SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87105",
            "telephone_number": "505-873-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUM",
        "first_name": "MARK",
        "middle_name": "DYAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Christine Bruch, PHD, LMFT
• Natalia Bruciaga
• Katherine Cecilia Brueggemann
• Deanna C. Bruer, LMHC, NCC, LSAA
• Rober Dale Brugger, PHYSICIAN ASSISTANT
• Susan Brumbaugh, LPCC
• Lisa M Brunacini, DDS
• Rachel Brunacini, LM, CPM
• Aimee Brunell-Malik, LMHC
• Andrew Bruner, M.D.

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.