Shola David Anifowose

Primary specialty

DentistTaxonomy code 122300000X

License

DD4751 Issued in NM

Practice address

2330 W Pierce St
Carlsbad, NM 88220-3514

Phone

(888) 988-4066

Fax

(888) 988-4066

NPI assigned

Jul 17, 2017

Last updated

Jul 17, 2017By the provider in NPPES

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

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

• Olympic Crossing Dental

  • Dental Clinic/Center
  • McKinney, TX
  • NPI 1881488203
  NPD Authorized official
• Familia Dental Carlsbad LLC

  dba Familia Dental

  • General Practice Dentistry
  • Carlsbad, NM
  • NPI 1811333800
  NPD (past)
• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1972569820
  NPD (past)

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1922521475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203514",
            "telephone_number": "888-988-4066",
            "fax_number": "888-988-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIFOWOSE",
        "first_name": "SHOLA",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ams Enterprises LLC (LaTienda Pharmacy)
• Debra Anaya, LPCC
• Patricia Gail Anaya, LCSW
• Kimber Lee Andersen, LMSW
• Sarah Elaine Anderson, PTA
• App of New Mexico Ed PLLC
• App of New Mexico HM PLLC
• Michelle Aragon, PMHNP-BC
• Surpreet Singh Arora, D.D.S
• Artesia General Hospital (Carlsbad Family Practice)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.