MARK BENTLEY BLEAK (NPI# 1407046360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407046360 |
| Entity Type | Individual |
| Full Name | MARK BENTLEY BLEAK |
| Credential | DMD |
| Practice Address |
1001 W Broadway Ste D Farmington NM 87401-5638 |
| Practice Telephone | 5053259133 |
| Mailing Telephone | 5053259133 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DD2905 | NM | Dental Providers |
| Street Address |
1001 W BROADWAY STE D |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336132356 | Darren Powell | Counselor | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2005-08-24 |
| 1376142679 | Michelle M Medina | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2020-10-19 |
| 1972117729 | Valaria Lisa Kee | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2020-08-31 |
| 1255952826 | Breanna Smith | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2020-05-05 |
| 1518506724 | Joni J Duran | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2020-01-06 |
| 1144867706 | Marlene Jim | Behavioral Analyst | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2019-12-03 |
| 1417503483 | James Andrew Bigham | Nurse Practitioner | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2019-08-14 |
| 1679125124 | Joshua Norris Powell | Social Worker | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2019-07-15 |
| 1043870330 | Karen A Silversmith | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2019-06-18 |
| 1215595343 | Summer Popplewell | Case Manager/Care Coordinator | 1001 W Broadway Ste D, Farmington, NM 87401-5638 | 2019-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| 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 |
|---|---|---|---|---|
| 1790273373 | Cameron Seymour | Dentist | 291 Farmington Ave Ste 5, Farmington, CT 06032 | 2018-04-29 |
| 1043662802 | Derek Edward Owens | Dentist | 3030 E Main St Ste T1, Farmington, NM 87402-7627 | 2016-07-05 |
| 1992155568 | Jeff Blomstedt | Dentist | 1510 E 20th St, Suite B, Farmington, NM 87401-9033 | 2016-06-15 |
| 1952781346 | Jenna Palmer | Dentist | 20700 Chippendale Ave W Ste 10, Farmington, MN 55024-8206 | 2015-06-01 |
| 1942604533 | Ryan H Wilson Dds LLC | Dentist | 4760 N Butler Ave Ste D, Farmington, NM 87401-0816 | 2014-10-10 |
| 1649693284 | Farmington Family Dental Pllc | Dentist | 34405 Grand River, Farmington, MI 48335 | 2014-02-03 |
| 1558790378 | Dr David Herman's Four Corners Dental, LLC | Dentist | 3751 N Butler Ave Ste 113, Farmington, NM 87401-6425 | 2013-11-02 |
| 1235487851 | John William Loberg | Dentist | 2650 E Pinon Frontage Rd Bldg 200, Farmington, NM 87402-5084 | 2012-08-29 |
| 1265728547 | Remi Sarna | Dentist | 34505 Grand River Ave, Farmington, MI 48335-3311 | 2011-06-24 |
| 1912223058 | Manu Mohan Sachdev | Dentist | 52 N 1100 W, Farmington, UT 84025-2181 | 2010-04-14 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
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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.