DR. AUDREY A NAVARRO (NPI# 1215290390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215290390 |
| Entity Type | Individual |
| Full Name | DR. AUDREY A NAVARRO |
| Credential | D.D.S. |
| Practice Address |
4620 Jefferson Ln Ne Ste C Albuquerque NM 87109-2149 |
| Practice Telephone | 5058883520 |
| Mailing Telephone | 5058883520 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-03-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 2646 | HI | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DD5246 | NM | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2646 | HI | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DD4404 | NM | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1111 S Grand Ave Apt 503, Los Angeles, CA 900152755 | 9515437439 | |
| 74-5214 Keanalehu Dr, Kailua Kona, HI 96740 | 8083555650 |
| Street Address |
4620 JEFFERSON LN NE STE C |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134334907 | Colin Simeon Shaw | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2120 | 2007-05-14 |
| 1386243640 | Ohana Orthodontics LLC | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2149 | 2020-10-19 |
| 1558994582 | Rawson Pediatric Dental Group | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2149 | 2020-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113197 | Aragon Pediatric Dentistry LLC | Dentist | 8300 Carmel Ave Ne Ste 60, Albuquerque, NM 87122-3147 | 2020-10-28 |
| 1982264545 | A To Z Children's Dentistry - Westside, LLC | Dentist | 3301 Coors Blvd Nw Ste I, Albuquerque, NM 87120-4720 | 2019-06-17 |
| 1376047795 | Anne K. Hempstead D.d.s., P.C. | Dentist | 6400 Holly Ave Ne Ste M, Albuquerque, NM 87113 | 2018-03-20 |
| 1497008312 | Sandia Pediatric Dentistry | Dentist | 7007 Wyoming Blvd Ne Ste C-2, Albuquerque, NM 87109-3987 | 2012-10-16 |
| 1033381603 | Spencer Tasker Pediatric Dentistry | Dentist | 9201 Eagle Ranch Rd Nw, Albuquerque, NM 87114-6032 | 2008-03-24 |
| 1518022862 | Rachelle L Shaw | Dentist | 4620 Jefferson Lane, Suite C, Albuquerque, NM 87109 | 2006-12-27 |
| 1629149851 | Spencer John Tasker | Dentist | 8201 Golf Course Rd Nw, Ste C-3, Albuquerque, NM 87120-5842 | 2006-11-10 |
| 1124016191 | Stephen Michael Cito | Dentist | 3900 Eubank Blvd Ne, Albuquerque, NM 87111-3465 | 2005-10-12 |
| 1891317426 | Tasker, Hatch, Rowan, LLC | Dentist | 9201 Eagle Ranch Rd Nw, Albuquerque, NM 87114-6440 | 2020-05-18 |
| 1558994582 | Rawson Pediatric Dental Group | Dentist | 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2149 | 2020-02-18 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on DR. AUDREY A NAVARRO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.