ALBUQUERQUE MODERN DENTISTRY, LLC (NPI# 1487953790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487953790 |
| Entity Type | Organization |
| Organization Name | ALBUQUERQUE MODERN DENTISTRY, LLC |
| Other Organization Name | ALBUQUERQUE MODERN DENTISTRY |
| Practice Address |
2800- A Coors Blvd Nw Albuquerque NM 87120-1204 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 5053521166 |
| Practice Fax Number | 5053522805 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2013-11-18 |
| Authorized Official Name | DR. MARIO HERREJON-RUIZ (OWNER DOCTOR) |
| Authorized Official Telephone | 5053521166 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Albuquerque Modern Dentistry | Doing Business As Name - Organization |
| Street Address |
2800- A COORS BLVD NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87120-1204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971919 | Erica Denise Ortiz | Social Worker | 6212 Casa Blanca Dr Nw, Albuquerque, NM 87120 | 2020-10-27 |
| 1770133589 | Laura Lee Smith | Technician | 5112 Vista De Luz Nw, Albuquerque, NM 87120 | 2019-09-13 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1831753508 | Jennifer Lydia Castro | Nurse Practitioner | 8428 Hawk Eye Rd Nw, Albuquerque, NM 87120 | 2019-04-27 |
| 1518425065 | Jean Louise Ramsey | Counselor | Office Alternatives/ The Center for Life Changes, 6300 Riverside Plaza Nw, Suite 100, Albuquerque, NM 87120 | 2019-03-04 |
| 1689147365 | Stairway Recovery, LLC | Family Medicine | 6300 Riverside Plaza Ln Nw Ste 118 #96523, Albuquerque, NM 87120 | 2019-01-06 |
| 1417443276 | Kyle Thomas Lantz | Dentist | 2800-a Coors Blvd Nw, Albuquerque, NM 87120 | 2018-07-05 |
| 1437669736 | Beatrice Ottomanelli | Day Training/Habilitation Specialist | 9180 Coors Blvd. Nw, Apt. 3307, Albuquerque, NM 87120 | 2017-10-02 |
| 1740705516 | Alianza Home Care, LLC | Home Health | 8307 Casa Negra Ct Nw, Albuquerque, NM 87120 | 2017-08-13 |
| 1366963399 | Jamie Farris | Registered Nurse | 8201 Golf Course Road Northwest, Suite D3 #121, Albuquerque, NM 87120 | 2017-06-29 |
| Find all providers in zip 87120 | ||||
| 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 |
|---|---|---|---|---|
| 1841803830 | Tri Dental, LLC | Dentist | 3715 Las Estancias Ct Sw Ste 101, Albuquerque, NM 87121-5506 | 2020-08-28 |
| 1609485077 | Joseph Potter | Dentist | 3510 Coors Blvd Sw, Albuquerque, NM 87121-5328 | 2020-07-30 |
| 1861024861 | Brian K Dennis Dds PC | Dentist | 8400 Osuna Rd Ne Ste 6a, Albuquerque, NM 87111-2073 | 2020-02-07 |
| 1134769235 | Abq Dentists PC | Dentist | 3900 Eubank Blvd Ne Ste 14, Albuquerque, NM 87111-3427 | 2020-01-07 |
| 1477197804 | Juan Tabo Dentistry LLC | Dentist | 1924 Juan Tabo Blvd Ne Ste C, Albuquerque, NM 87112-3358 | 2019-10-29 |
| 1013550094 | Bosque Smiles Dentistry, LLC | Dentist | 5600 Coors Blvd Nw Ste G4, Albuquerque, NM 87120-1877 | 2019-10-23 |
| 1134686298 | Brandon James Clayton | Dentist | 2003 Southern Blvd Se # 133-134, Albuquerque, NM 87124-3751 | 2019-02-25 |
| 1881158822 | Advantage Dental Care | Dentist | 9212 Montgomery Blvd Ne, Albuquerque, NM 87111-2408 | 2019-01-23 |
| 1124599253 | Kirtland Family Dentistry LLC | Dentist | 8521 Central Ave Ne Ste 101, Albuquerque, NM 87108-2501 | 2018-12-16 |
| 1962998443 | Salia Khayoumi | Dentist | 333 San Mateo Blvd Se, Albuquerque, NM 87108-2919 | 2018-07-08 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87120 |
Please comment or provide details below to improve the information on ALBUQUERQUE MODERN DENTISTRY, LLC.
| 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.