EDGEWOOD FAMILY DENTISTRY (NPI# 1316917495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316917495 |
| Entity Type | Organization |
| Organization Name | EDGEWOOD FAMILY DENTISTRY |
| Practice Address |
1917 Old Highway 66 Edgewood NM 87015-0000 |
| Mailing Address |
Po Box 2560 Edgewood NM 87015-2560 |
| Practice Telephone | 5052810373 |
| Practice Fax Number | 5052810373 |
| Mailing Telephone | 5052810373 |
| Mailing Fax Number | 5052810373 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. STEPHEN L HARRINGTON (OWNER) |
| Authorized Official Telephone | 5052810373 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
NM1580 | NM | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | SUE'S NM LISC # | NM1625 | 01 |
| NM | STEVE'S NM LISC # | NM1580 | 01 |
| Street Address |
1917 OLD HIGHWAY 66 |
| City | EDGEWOOD |
| State | NM |
| Zip Code | 87015-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740772490 | Laura Hunsucker | Physical Therapist | 1090 Mountain Valley Road, Edgewood, NM 87015 | 2018-05-30 |
| 1295194629 | Ryan Grange | Physician Assistant | 1851 Old Highway 66 Unit 1, Edgewood, NM 87015 | 2016-02-12 |
| 1376895250 | Bianca Genco-morrison | Social Worker | 17 Venus Rd. West, Edgewood, NM 87015 | 2012-10-03 |
| 1447541909 | Rona H Vanwilligen | Physical Therapist | 1851 Highway 333, 2-b, Edgewood, NM 87015 | 2011-05-02 |
| 1679717789 | Alan Mannheimer | Pediatrics | 104 Quail Trail, Unit B, Edgewood, NM 87015 | 2009-04-21 |
| 1003085705 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 66 State Road #344, Edgewood, NM 87015 | 2008-02-27 |
| 1821270828 | Fowler Enterprises, Inc. | Physical Therapist | 1851-2b Old Highway 66, Edgewood, NM 87015 | 2007-11-30 |
| 1366630121 | Jeana Spindle | Speech-Language Pathologist | 27 Camino Estribor, Edgewood, NM 87015 | 2007-10-05 |
| 1679794457 | Sharon Louise Meyer | Social Worker | 14 El Prado, Edgewood, NM 87015 | 2007-05-01 |
| 1912035478 | Cecilia Gonzales Morris | Occupational Therapist | 204 Dinkle Road, Edgewood, NM 87015 | 2007-02-28 |
| Find all providers in zip 87015 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639712797 | Dan Roberts, Dmd, Pllc | Dentist | 2603 110th Ave E, Edgewood, WA 98372-1846 | 2019-10-22 |
| 1740775022 | Zachcurriedds LLC | Dentist | 1851 Old Us 66 Ste C, Edgewood, NM 87015-6784 | 2018-06-28 |
| 1669885398 | Cory Matthew Middendorf | Dentist | 155 Barnwood Drive, Suite 1, Edgewood, KY 41017 | 2014-06-10 |
| 1548389422 | Timothy Gerald Hardtke | Dentist | 2222 Meridian Ave E, Suite C, Edgewood, WA 98371-1032 | 2007-03-29 |
| 1942328364 | Peter Hamilton Roth | Dentist | 1308 Business Center Way, Suite 105, Edgewood, MD 21040-1504 | 2007-03-26 |
| 1396870861 | Stephen L Harrington | Dentist | 1851 Old Hwy 66, Suite C, Edgewood, NM 87015 | 2007-02-23 |
| 1609901172 | Suzanne Mcginty | Dentist | 1917 Old Hwy 66, St. A, Edgewood, NM 87015 | 2007-02-23 |
| 1205971082 | Kevin Robert Mcmahon | Dentist | 155 Barnwood Dr, Suite 1, Edgewood, KY 41017-2585 | 2007-02-20 |
| 1194736363 | Keavin G Mcintosh | Dentist | 2511 Meridian Ave E, Edgewood, WA 98371-2164 | 2006-08-11 |
| 1225052582 | Sharon Elaine Reynolds Lundgren | Dentist | 2104 Trimble Rd, Edgewood, MD 21040-3119 | 2006-07-27 |
| Find all providers in EDGEWOOD | ||||
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| 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.