SANDIA PLASTIC SURGERY, PC (NPI# 1407171408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407171408 |
| Entity Type | Organization |
| Organization Name | SANDIA PLASTIC SURGERY, PC |
| Practice Address |
801 Encino Place Ne Suite D7 Albuquerque NM 87102 |
| Practice Telephone | 5058420066 |
| Practice Fax Number | 5058429325 |
| Mailing Telephone | 5058420066 |
| Mailing Fax Number | 5058429325 |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2015-04-15 |
| Authorized Official Name | JENNIFER W.H. CHAN (OWNER/SOLE MEMBER) |
| Authorized Official Telephone | 5058420066 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | MD2007-0451 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
801 ENCINO PLACE NE SUITE D7 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609065184 | American Current Care P.a. | Clinic/Center | 801 Encino Place Ne, Suite E-12, Albuquerque, NM 87102 | 2007-10-19 |
| 1851752497 | Dawn Kristin Bustamante | Nurse Practitioner | 801 Encino Place Ne, Suite A6, Albuquerque, NM 87102 | 2016-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184763195 | Jennifer Chan | Plastic Surgery | Sandia Plastic Surgery, 1020 Tijeras Ave. Ne, Albuquerque, NM 87106-4749 | 2007-02-06 |
| 1518045657 | New Mexico Plastic | Plastic Surgery | 1020 Tijeras Ave Ne Ste 16, Albuquerque, NM 87106-4749 | 2006-11-02 |
| 1336226075 | Miguel Lorenzo Gallegos | Plastic Surgery | 8004 Constitution Pl Ne, Albuquerque, NM 87110-7628 | 2006-11-01 |
| 1124033600 | Cesar Luis Cuadros | Plastic Surgery | 8232 Louisiana Blvd Ne Ste A, Albuquerque, NM 87113-2429 | 2006-07-30 |
| 1720011315 | Aaron J Mayberry | Plastic Surgery | 7115 Prospect Pl Ne, Albuquerque, NM 87110-4313 | 2006-07-08 |
| 1871931386 | Garrett Daniel Wegerif | Plastic Surgery | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2013-06-06 |
| 1043402274 | Richard Charles Gobeille | Plastic Surgery | 2601 Wyoming Blvd Ne, Suite 205, Albuquerque, NM 87112-1035 | 2007-08-12 |
| 1700076239 | Jeffrey Wu | Plastic Surgery | 2211 Lomas Blvd Ne Fl 2, Unm Surgical Plastic Surgery Clinic, Albuquerque, NM 87106-2719 | 2007-07-31 |
| 1659570950 | William G. Loutfy | Plastic Surgery | 10400 Academy Rd Ne, #230, Albuquerque, NM 87111-1229 | 2007-07-16 |
| 1215058359 | Anil Shetty | Plastic Surgery | 2211 Lomas Blvd Ne, University of New Mexico Health Sciences Center, Albuquerque, NM 87106-2719 | 2007-04-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
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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.