SANTA FE MODERN DENTISTRY AND ORTHODONTICS, LLC (NPI# 1689950008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689950008 |
| Entity Type | Organization |
| Organization Name | SANTA FE MODERN DENTISTRY AND ORTHODONTICS, LLC |
| Other Organization Name | SANTA FE MODERN DENTISTRY AND ORTHODONTICS |
| Practice Address |
3569 Zafarano Boulevard Santa Fe NM 87507 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 5059868000 |
| Practice Fax Number | 5059820374 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2013-12-31 |
| Authorized Official Name | DR. KELLEY HOLLINGSWORTH RYALS (OWNER DOCTOR) |
| Authorized Official Telephone | 5059868000 |
| Authorized Official Credential | DDS |
| 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 |
|---|---|
| Santa Fe Modern Dentistry and Orthodontics | Doing Business As Name - Organization |
| Street Address |
3569 ZAFARANO BOULEVARD |
| City | SANTA FE |
| State | NM |
| Zip Code | 87507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316390 | Cynthia Lois Meyers | Pharmacy | 2709 Cerrillos Road, Santa Fe, NM 87507 | 2020-11-03 |
| 1578160685 | Nancy Benigsohn | Counselor | 4001 Office Courte., Suite 603, Santa Fe, NM 87507 | 2020-10-02 |
| 1730684853 | Presbyterian Healthcare Services | General Acute Care Hospital | 4801 Beckner Road, Santa Fe, NM 87507 | 2018-03-29 |
| 1033623780 | Averie Montgomery-diener | Physical Therapy Assistant | 2538 Camino Entrad Suite 300, Santa Fe, NM 87507 | 2017-11-16 |
| 1013426790 | Deja Nicole Mendez | Behavior Technician | 2213 Paseo De Tercero, Santa Fe, NM 87507 | 2017-09-25 |
| 1548787633 | Lauren Sherwood | Behavior Technician | 4129 S Meadows Rd, Apt #1023, Santa Fe, NM 87507 | 2017-08-29 |
| 1972032563 | Alyssa Butler | Counselor | 1409 Zepol Rd Apt 110, Santa Fe, NM 87507 | 2017-06-07 |
| 1093253221 | Stateserv Medical | Durable Medical Equipment & Medical Supplies | 4326 Airport Road, Unit F, Santa Fe, NM 87507 | 2017-02-08 |
| 1891233128 | Daniel & Max, LLC | Optometrist | 4079 Cerillos Road, Santa Fe, NM 87507 | 2017-02-07 |
| 1508225749 | Youth Shelters and Family Services | Counselor | 5686 B Agua Fria Street, Santa Fe, NM 87507 | 2016-02-16 |
| Find all providers in zip 87507 | ||||
| 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 |
|---|---|---|---|---|
| 1649802604 | Manpreet Kaur Randhawa | Dentist | 4111 Fm 1764 Rd Ste E, Santa Fe, TX 77517-3854 | 2020-02-07 |
| 1285264242 | Professional Dental Care Pllc | Dentist | 550 Saint Michaels Dr Ste 2, Santa Fe, NM 87505-7604 | 2020-01-18 |
| 1912492406 | Aurora Dental Nm LLC | Dentist | 3875 Cerrillos Rd, Santa Fe, NM 87507-4145 | 2018-06-27 |
| 1861910283 | Alliance Oral Health Care, P.C. | Dentist | 130 Siringo Rd Ste 201, Santa Fe, NM 87505-5864 | 2017-09-06 |
| 1104278837 | Varun Yadav | Dentist | 1406 Luisa St Ste 1, Santa Fe, NM 87505-4161 | 2016-07-06 |
| 1982062048 | Santa Fe Dentist Office, LLC | Dentist | 5131 Main Street, 101, Santa Fe, NM 87507 | 2016-02-04 |
| 1730424904 | Elizabeth M. Wilson Dmd LLC | Dentist | 217 E Marcy St, Santa Fe, NM 87501-2020 | 2012-11-29 |
| 1437440286 | Katarzyna Ujda | Dentist | 2019 Galisteo St Ste L2, Santa Fe, NM 87505-2112 | 2011-04-27 |
| 1962718213 | Laura Comeau Dds PC | Dentist | 2100 Calle De La Vuelta Unit E105, Santa Fe, NM 87505-4819 | 2010-08-25 |
| 1649420928 | Michael Barnett Clayman | Dentist | 3057 Monte Sereno Dr, Santa Fe, NM 87506-0186 | 2008-09-24 |
| Find all providers in SANTA FE | ||||
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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.