NIRVANA LLC (NPI# 1710137773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710137773 |
| Entity Type | Organization |
| Organization Name | NIRVANA LLC |
| Practice Address |
161 Railcar Rd Corrales NM 87048-7909 |
| Practice Telephone | 5055536850 |
| Mailing Telephone | 5055536850 |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |
| Authorized Official Name | MS. JULIE RAYE FULLER (CO-OWNER) |
| Authorized Official Telephone | 5055536850 |
| Authorized Official Credential | RDH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | DH1235 | NM | Dental Providers |
| Y | 124Q00000X | Dental Hygienist | DH986 | NM | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 65028066 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | NIRVANA LLC | 7 Scofield Pl, Norwalk, CT 06855 |
| Virginia Business Entities | Nirvana LLC | 1145 Grove Park Lane, Earlysville, Virginia 22936 |
| Massachusetts Corporations | NIRVANA LLC | 10 Kathryn Road, Foxboro, MA 02035 |
| Street Address |
161 RAILCAR RD |
| City | CORRALES |
| State | NM |
| Zip Code | 87048-7909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730339789 | Lou A. Weingardt | Dental Hygienist | 161 Railcar Rd, Corrales, NM 87048-7909 | 2008-09-26 |
| 1477703429 | Julie Raye Fuller | Dental Hygienist | 161 Railcar Rd, Corrales, NM 87048-7909 | 2008-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154948081 | Designed Health Options, LLC | General Practice | 5065 Corrales Rd., Corrales, NM 87048 | 2020-06-26 |
| 1770102618 | Lisa Garcia | Technician | 148 West Valverde Rd., Corrales, NM 87048 | 2020-04-10 |
| 1841690732 | Erica Jacknin | Art Therapist | 100 Sherlock Ct, Corrales, NM 87048 | 2014-08-27 |
| 1821331182 | Celia Janet Larcom | Massage Therapist | 4650 Corrales Rd., Bldg. B, Corrales, NM 87048 | 2013-04-04 |
| 1740538693 | Angel Paths Therapy | Voluntary or Charitable | 817 West Ella, Corrales, NM 87048 | 2012-08-27 |
| 1013207356 | Meta, Inc. | Community/Behavioral Health | 4813 Corrales Road, Corrales, NM 87048 | 2011-04-07 |
| 1568602399 | Michael A Mauldin | Psychologist | 154 Anya Rd, Corrales, NM 87048 | 2009-03-06 |
| 1154568087 | Maria C Chavez | Counselor | 218 Broadway Ave, Abq, NM 87048 | 2009-01-14 |
| 1104073451 | Changing Life's Direction, LLC | Community/Behavioral Health | 4627 Corrales Rd., Corrales, NM 87048 | 2008-08-19 |
| 1467613604 | Natalie M Naranjo-rodriguez | Counselor | 20 Camino Vega Verde, Corrales, NM 87048 | 2008-06-20 |
| Find all providers in zip 87048 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730339789 | Lou A. Weingardt | Dental Hygienist | 161 Railcar Rd, Corrales, NM 87048-7909 | 2008-09-26 |
| 1477703429 | Julie Raye Fuller | Dental Hygienist | 161 Railcar Rd, Corrales, NM 87048-7909 | 2008-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940787 | Carrie Boehm | Dental Hygienist | 2844 E Main St Ste 106-145, Farmington, NM 87402-5260 | 2020-10-16 |
| 1205450939 | Aislinn B Grover | Dental Hygienist | Indian Service Rte 140 & Indian Service Route 125, Pinehill, NM 87357 | 2020-05-28 |
| 1669095188 | Julie Arneson | Dental Hygienist | 11 Sacred Vista Rd, El Prado, NM 87529 | 2020-05-19 |
| 1013540848 | Kelsi Marie Hartwig | Dental Hygienist | Highway 491 North, Yucca Street, Shiprock, NM 87420 | 2020-02-20 |
| 1841839099 | Naomi Lynn Amador | Dental Hygienist | 105 Golf Dr, Clovis, NM 88101-3145 | 2020-01-04 |
| 1972061539 | Mary Hilley | Dental Hygienist | 33 General Sage Dr, Santa Fe, NM 87505-6397 | 2019-03-03 |
| 1568930782 | Janelle K Mancha | Dental Hygienist | 9527 Night Sky Ln Ne, Albuquerque, NM 87122-1252 | 2018-11-06 |
| 1063988301 | Sarah Adele Sisneros | Dental Hygienist | 333 San Mateo Blvd Se Ste A, Albuquerque, NM 87108-2919 | 2018-10-14 |
| 1356825186 | Roberta Rodriguez | Dental Hygienist | 15136 St Hwy 75, Penasco, NM 87553 | 2018-09-18 |
| 1285125658 | Alicia T Medrano | Dental Hygienist | 1105 Golf Course Rd Se Bldg A, Rio Rancho, NM 87124-4733 | 2018-05-22 |
| Find all providers with the same taxonomy | ||||
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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.