Individual provider Active NPI

Liilia Van Maanen

  • Dental Hygienist
  • Farmington, NM
National Provider Identifier
1982012456
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH4120 Issued in NM
Practice address
2700 Farmington Ave Ste 1
Farmington, NM 87401-4559
Phone
(505) 325-9133
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH4120 NM Primary

Addresses

Primary practice location

2700 Farmington Ave Ste 1
Farmington, NM 87401-4559

Mailing address

1309 E 27TH St
Farmington, NM 87401-9007
Phone (505) 258-2899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH4120NMMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1982012456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 E 27TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874019007",
            "telephone_number": "505-258-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 FARMINGTON AVE STE 1",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014559",
            "telephone_number": "505-325-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN MAANEN",
        "first_name": "LIILIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NM",
            "license": "DH4120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.