DR. JAKE BRADY WOLF (NPI# 1346655974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346655974 |
| Entity Type | Individual |
| Full Name | DR. JAKE BRADY WOLF |
| Credential | D.D.S. |
| Practice Address |
1310 E Pine St Suite B Deming NM 88030-7003 |
| Mailing Address |
8201 Golf Course Rd Nw Albuquerque NM 87120-5842 |
| Practice Telephone | 5755449999 |
| Mailing Telephone | 5058929010 |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DD4108 | NM | Dental Providers |
| Street Address |
1310 E PINE ST SUITE B |
| City | DEMING |
| State | NM |
| Zip Code | 88030-7003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497301824 | Gila Regional Medical Center | Family Medicine | 901 S. Gold Avenue, Deming, NM 88030 | 2019-08-12 |
| 1437621943 | Lloyd's Water Pal Corporation | Pharmacist | 622 West First Street, Soon Other At Other : 8700 East Fourth Street, Deming, NM 88030 | 2018-12-21 |
| 1649768672 | Beatrice Kasey Jackson | Behavior Technician | 1411 S Socorro St, Deming, NM 88030 | 2018-04-25 |
| 1376062174 | Suzzana M Weber | Social Worker | 1321 E Poplar Ave, Deming, NM 88030 | 2017-09-12 |
| 1477073823 | Rocky Mountain Holdings Ll C | Ambulance | 2865 Raymond J. Reed Blvd Se, Deming, NM 88030 | 2017-06-26 |
| 1124419627 | Ambercare Medical Supply Co. | Durable Medical Equipment & Medical Supplies | 707 E Pine St, Suite A, Deming, NM 88030 | 2015-02-05 |
| 1508288598 | Brian Plasters | Case Manager/Care Coordinator | 9025 Hwy 377 Ne, Deming, NM 88030 | 2014-01-10 |
| 1275884785 | Marcos A Reyna | Counselor | 125 Chaparral Blvd. Nw, Deming, NM 88030 | 2012-09-24 |
| 1487963831 | Juanita A. Smith | Case Manager/Care Coordinator | 901 West Hickory, Deming, NM 88030 | 2010-10-04 |
| 1659504231 | Marylou H Lozano | Case Manager/Care Coordinator | 901 West Hickory St, Deming, NM 88030 | 2009-08-28 |
| Find all providers in zip 88030 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750491866 | John Lynn Gordon | Dentist | 1315 South 8th, Deming, NM 88030 | 2006-08-30 |
| 1285091181 | Southern New Mexico Orthodontics LLC | Dentist | 1310 E Pine St Ste B, Deming, NM 88030-7003 | 2016-01-22 |
| 1376968719 | Jillana Pollard | Dentist | 125 Chaparrel Blvd Nw, Deming, NM 88030-8629 | 2014-02-21 |
| 1679903355 | Richard S Bohnstedt | Dentist | 125 Chaparrel Blvd Nw, Deming, NM 88030-8629 | 2013-11-18 |
| 1801963863 | James J O Connell | Dentist | 400 S Gold Ave, Deming, NM 88030 | 2006-11-28 |
| 1588761910 | Howard Neville Rhoads | Dentist | 125 Chaparrel Blvd Nw, Deming, NM 88030-8629 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959934 | Comfortable Dentistry 4u - Cottonwood, LLC | Dentist | 3613 Nm 528 Nw Ste D, Albuquerque, NM 87114-8918 | 2020-10-15 |
| 1295347326 | Sandya Vanathi Athigaman | Dentist | 612 N Canyon St, Carlsbad, NM 88220-5842 | 2020-08-19 |
| 1932729506 | Brenda Concepcion Acosta | Dentist | Aegd-1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-04-23 |
| 1730712357 | Dental Technology Trainers LLC | Dentist | 3 Calle Del Arroyo, Placitas, NM 87043-9407 | 2020-02-21 |
| 1942833199 | Salud Dental Group Albuquerque | Dentist | 3803 Atrisco Dr Nw Ste D, Albuquerque, NM 87120-4958 | 2020-02-17 |
| 1669012241 | Lc Sleep Solutions LLC | Dentist | 2001 E Lohman Ave Ste 122, Las Cruces, NM 88001-3195 | 2020-01-10 |
| 1255987616 | Katelyn Noelle Bobbitt | Dentist | 950 Unser Blvd Se Ste 100, Rio Rancho, NM 87124-6376 | 2019-08-12 |
| 1336793892 | Lee Paige Affholter | Dentist | 6349 Us 550, Cuba, NM 87013 | 2019-08-01 |
| 1073167789 | Kathryn Susanne Wynne | Dentist | 5131 Main St Ste 101, Santa Fe, NM 87507-2682 | 2019-07-31 |
| 1033770953 | Chad Joseph Davis | Dentist | 3811 Cerrillos Rd Ste 104, Santa Fe, NM 87507-4149 | 2019-06-21 |
| Find all providers with the same taxonomy | ||||
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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.