NPIMap

Organization Active NPI

New Mexico Department of Health

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1912024027
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD1302 Issued in NM
Legal business name
NEW MEXICO DEPARTMENT OF HEALTH
Doing business as
New Mexico Department of Health, Special Needs Dental Clinic
Practice address
7905 Marble Ave NE
Albuquerque, NM 87110-7886
Phone
(505) 232-5710
Fax
(505) 232-5720
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Authorized official

Name
Mr. Jim Copeland
Title
DDSD Director
Phone
(505) 660-3453

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DD1302 NM Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DD3457 NM

Addresses

Primary practice location

7905 Marble Ave NE
Albuquerque, NM 87110-7886

Mailing address

7905 Marble Ave. NE
Albuquerque, NM 87110-7886
Phone (505) 232-5710

Other identifiers 1

IdentifierTypeStateIssuer
89623MedicaidNM

Other names 1

  • New Mexico Department of Health, Special Needs Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Scientific Laboratory Division Nmdoh43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

7905 Marble Ave NE
Albuquerque, NM 87110
Phone (505) 232-5710

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531094400000",
    "number": "1912024027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7905 MARBLE AVE. NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107886",
            "telephone_number": "505-232-5710",
            "fax_number": "505-232-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7905 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107886",
            "telephone_number": "505-232-5710",
            "fax_number": "505-232-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2018-07-09",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "DDSD DIRECTOR",
        "authorized_official_telephone_number": "505-660-3453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD1302",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3457",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89623",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico Department of Health, Special Needs Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 9, 2018; 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.