NPIMap

Organization Active NPI

Abq Dentures, LLC

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1972052652
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD3069 Issued in NM
Legal business name
ABQ DENTURES, LLC
Practice address
2010-K Wyoming Blvd. NE
Albuquerque, NM 87112-2678
Phone
(505) 344-4948
NPI assigned
Sep 23, 2016
Last updated
Sep 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Authorized official

Name
Dr. Peter Roukema, DMDNPI 1457525263
Title
Member
Phone
(216) 374-5693

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DD3069 NM Primary

Addresses

Primary practice location

2010-K Wyoming Blvd. NE
Albuquerque, NM 87112-2678

Mailing address

2010-K Wyoming Blvd. NE
Albuquerque, NM 87112-2678

National Provider Directory

National Provider Directory

Locations

2010 Wyoming Blvd NE
Ste K
Albuquerque, NM 87112
Phone (505) 344-4948

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": "1474588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474588800000",
    "number": "1972052652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010-K WYOMING BLVD. NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010-K WYOMING BLVD. NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122678",
            "telephone_number": "505-344-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABQ DENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A",
        "authorized_official_last_name": "ROUKEMA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "216-374-5693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 23, 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.