SAN JUAN COLLEGE (NPI# 1679740013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679740013 |
| Entity Type | Organization |
| Organization Name | SAN JUAN COLLEGE |
| Practice Address |
4601 College Blvd Dental Clinic Farmington NM 87402-4609 |
| Mailing Address |
4601 College Blvd Farmington NM 87402-4609 |
| Practice Telephone | 5055663126 |
| Practice Fax Number | 5055663790 |
| Mailing Telephone | 5055663126 |
| Mailing Fax Number | 5055663790 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | DR. CAROL SPENCER (PRESIDENT) |
| Authorized Official Telephone | 5055663209 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DD-2461 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 59457538 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538414727 | San Juan College | Community/Behavioral Health | 4601 College Blvd, Farmington, NM 87402-4609 | 2012-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAN JUAN COLLEGE | 4601 College Blvd, Farmington, NM 87402-4609 |
| Street Address |
4601 COLLEGE BLVD DENTAL CLINIC |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87402-4609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992701601 | Julius Nicholas Manz | Dentist | 4601 College Blvd, Farmington, NM 87402-4609 | 2005-06-27 |
| 1538414727 | San Juan College | Community/Behavioral Health | 4601 College Blvd, Farmington, NM 87402-4609 | 2012-07-13 |
| 1780959304 | Teresa L Bigelow | Physical Therapy Assistant | 4601 College Blvd, Farmington, NM 87402-4609 | 2012-03-14 |
| 1417281015 | Nicole K Deherrera | Social Worker | 4601 College Blvd, Farmington, NM 87402-4609 | 2009-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285127803 | Guy Mearle Youell Jr. | Physical Therapy Assistant | 3701 Messina Dr. #108, Farmington, NM 87402 | 2018-06-08 |
| 1740612498 | Four Corners Sleep Supplies | Durable Medical Equipment & Medical Supplies | 6600 East Main St, Suite B, Farmington, NM 87402 | 2013-08-05 |
| 1528400199 | Cloud 9 Sleep Center | Clinic/Center | 6600 E Main St, Suite C, Farmington, NM 87402 | 2013-07-24 |
| 1023395027 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2844 E Main St Ste 105, Farmington, NM 87402 | 2011-11-04 |
| 1356530927 | Brimhall Chiropractic Wellness LLC | Chiropractor | 6610 E Main St, Farmington, NM 87402 | 2007-10-19 |
| 1548468184 | Susan L Burns | Hearing Instrument Specialist | 4331 E. Main St., Suite 202, Farmington, NM 87402 | 2007-07-05 |
| 1205031945 | Joanne Christine Rhodus | Speech-Language Pathologist | 6417 Red Rock Ct, Farmington, NM 87402 | 2007-06-20 |
| 1487867875 | Harvey R. Weber | Dentist | 4725 Foothills Dr., Farmington, NM 87402 | 2007-05-08 |
| 1891834891 | Rex Baker | Family Medicine | 4820 East Main St, Farmington, NM 87402 | 2007-02-06 |
| 1568531481 | Portia Deanne Sykes | Neuromusculoskeletal Medicine, Sports Medicine | 8100 East Main Street, Farmington, NM 87402 | 2006-11-07 |
| Find all providers in zip 87402 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159147 | Station Park Dental LLC | Clinic/Center | 1060 W Park Ln Ste 110, Farmington, UT 84025-2992 | 2018-10-01 |
| 1285887448 | Timothy M. O'bryan Dds, LLC | Clinic/Center | 12 E Harrison St, Farmington, MO 63640-1859 | 2008-10-30 |
| 1053923656 | Family Dentistry of Farmington | Clinic/Center | 24001 Orchard Lake Rd Ste 160, Farmington, MI 48336-2553 | 2020-08-17 |
| 1619514718 | Farmington Dental Pllc | Clinic/Center | 200 Mountain Rd, Farmington, CT 06032-2479 | 2019-12-08 |
| 1619446077 | Cordell Lake, D.d.s., LLC | Clinic/Center | 12 E Harrison St, Farmington, MO 63640-1859 | 2018-11-15 |
| 1598193088 | Derek Graff Dmd Ltd | Clinic/Center | 3180 N Butler Ave, Bldg 200, Farmington, NM 87401-2334 | 2013-10-22 |
| 1417200932 | Compassion Dental 06032 | Clinic/Center | 222 Main St, #251, Farmington, CT 06032-3623 | 2012-10-22 |
| 1962760462 | Pdg, P.a. | Clinic/Center | 511 Elm St, Farmington, MN 55024-1126 | 2012-05-03 |
| 1295937977 | Westmount Dental Arts | Clinic/Center | 1273 Doctors Dr, Farmington, MO 63640-2947 | 2007-06-04 |
| 1922029768 | University Dentists | Clinic/Center | 263 Farmington Ave, Mc2105, Farmington, CT 06030-0001 | 2006-07-21 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87402 |
Please comment or provide details below to improve the information on SAN JUAN COLLEGE.
| 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.