Brendan James Deline, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD5636 Issued in NM

Practice address

145 Don Pasqual Rd NW
Los Lunas, NM 87031-8841

Phone

(505) 224-8740

NPI assigned

Apr 13, 2021

Last updated

Oct 6, 2022By 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 2

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

Practice roles

Locations

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.

• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1902993132
  Medicare reassignment NPD
• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albuquerque, NM
  • NPI 1205097490
  NPD
• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Belen, NM
  • NPI 1447411632
  NPD
• First Choice Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Los Lunas, NM
  • NPI 1649431834
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1992385819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 DON PASQUAL RD NW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318841",
            "telephone_number": "505-224-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 DON PASQUAL RD NW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318841",
            "telephone_number": "505-224-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELINE",
        "first_name": "BRENDAN",
        "middle_name": "JAMES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5636",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher James Deanda, PHARMD
• Geoffery T Decker
• Debra Dederich-Elsner, LPCC
• Rosalind Monica Degeorge, PA-C
• Catherine Ann Delaney, PA-C
• Tina Delwiche
• Desert Sage Counseling & Consulting
• Devine Family Healthcare
• Jazmine Diaz
• Divine Wellness and Primary Care LLC

• General Practice Dentistry in Los Lunas, NM
• Providers in Los Lunas, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.