John J Candelaria, D.D.S.
Individual provider Active NPI General Practice Dentistry · Belen, NM
NPI 1982692091 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982692091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DD2298 (NM)
- Practice address
- 120 S 9TH St
Belen, NM 87002-3102 - Phone
- (505) 861-1013
- NPI assigned
- Oct 12, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD2298 | NM | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DD2298 | NM | Yes |
Addresses
Primary practice location
120 S 9TH St
Belen, NM 87002-3102
Mailing address
6628 Deerbourne Rd NW
Albuquerque, NM 87114-4726
Phone (505) 899-9772
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26985579 | Medicaid | NM |
Other providers in Belen, NM
- Randy Wayne Burden
- Holly Burks
- Lisa Burnson
- Alexandria Xaline Candelaria
- Amanda R Candelaria
- Silvia Castaneda
- Carolyn C Castillo-Ashford
- Brandy Lee Castillo
- Cecil C Sandoval DDS PA
- Russell Blaine Chadwick
All providers in Belen, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.