NPIMap

Organization Active NPI

Stockton 22, Inc.

Doing business as Copper Canyon Family Dentistry

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1912395302
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
STOCKTON 22, INC.
Doing business as
Copper Canyon Family Dentistry
Practice address
6830 Montgomery Blvd NE
Suite a
Albuquerque, NM 87109-1456
Phone
(505) 830-9081
Fax
(505) 830-9086
NPI assigned
Jan 7, 2015
Last updated
Oct 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Seth StocktonNPI 1376825059
Title
Owner
Phone
(505) 830-9081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

6830 Montgomery Blvd NE
Suite a
Albuquerque, NM 87109-1456

Mailing address

6830 Montgomery Blvd NE
Suite a
Albuquerque, NM 87109-1456
Phone (505) 830-9081

Other names 1

  • Copper Canyon Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1912395302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 MONTGOMERY BLVD NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091456",
            "telephone_number": "505-830-9081",
            "fax_number": "505-830-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 MONTGOMERY BLVD NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091456",
            "telephone_number": "505-830-9081",
            "fax_number": "505-830-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKTON 22, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "STOCKTON",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-830-9081"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Copper Canyon Family Dentistry",
            "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 Oct 14, 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.

Verify at the official NPI Registry.