Southwest Periodontal and Implants

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

SOUTHWEST PERIODONTAL AND IMPLANTS

Practice address

3045 E University Ave Ste a
Las Cruces, NM 88011-9147

Phone

(575) 522-2477

Fax

(575) 521-3556

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Angela C Merritt

Title

Insurance Coordinator

Phone

(575) 522-2477

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jared Bauerle, DMD

  • Periodontics
  • Las Cruces, NM
  • NPI 1831477819
  NPD

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1972118685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 E UNIVERSITY AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880119147",
            "telephone_number": "575-522-2477",
            "fax_number": "575-521-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 E UNIVERSITY AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880119147",
            "telephone_number": "575-522-2477",
            "fax_number": "575-521-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PERIODONTAL AND IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "575-522-2477",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southwest Pain Center, LLC
• Southwest Regenerative Medicine LLC
• Southwest Sport and Spine Center Inc
• Southwest Ultrasound Services LLC
• Southwest Urology PC
• Southwest Vision Specialists, P.a.

• Periodontics in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Periodontics in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.