NPIMap

Organization Active NPI

Divine Dental of Santa Fe

  • Dentist
  • Santa Fe, NM
National Provider Identifier
1992904288
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD2351 Issued in NM
Legal business name
DIVINE DENTAL OF SANTA FE
Practice address
550 Saint Michaels Dr Ste B
Santa Fe, NM 87505-7610
Phone
(505) 471-7000
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Dr. Esmael R Valdez, D.D.SNPI 1366427791
Title
Co-Owner
Phone
(505) 454-8483

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DD2351 NM Primary

Addresses

Primary practice location

550 Saint Michaels Dr Ste B
Santa Fe, NM 87505-7610

Mailing address

550 Saint Michaels Dr Ste B
Santa Fe, NM 87505-7610
Phone (505) 471-7000

National Provider Directory

National Provider Directory

Locations

550 Saint Michaels Dr
Ste B
Santa Fe, NM 87505
Phone (505) 471-7000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1992904288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SAINT MICHAELS DR STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057610",
            "telephone_number": "505-471-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SAINT MICHAELS DR STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057610",
            "telephone_number": "505-471-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE DENTAL OF SANTA FE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "VALDEZ",
        "authorized_official_first_name": "ESMAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "505-454-8483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.