ALBUQUERQUE WEST SMILES YOUTH DENTISTRY, PC (NPI# 1730137217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730137217 |
| Entity Type | Organization |
| Organization Name | ALBUQUERQUE WEST SMILES YOUTH DENTISTRY, PC |
| Practice Address |
111 Coors Blvd Nw E-6 Albuquerque NM 87121-2006 |
| Mailing Address |
111 Coors Blvd Nw Ste E6 Albuquerque NM 87121-2009 |
| Practice Telephone | 5053523808 |
| Practice Fax Number | 5053523811 |
| Mailing Telephone | 5053523808 |
| Mailing Fax Number | 5053523811 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2014-09-30 |
| Authorized Official Name | MRS. KIM FREEMAN (REGIONAL MANAGER) |
| Authorized Official Telephone | 5053779911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 77532 | 05 |
| Street Address |
111 COORS BLVD NW E-6 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87121-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508840554 | Lorraine F Ziegler | Dental Hygienist | 111 Coors Blvd Nw, Suite E1, Albuquerque, NM 87121-2006 | 2005-12-02 |
| 1518579697 | Nestor S Macias Jr. | Pharmacist | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2020-08-19 |
| 1457786782 | Jc Thomas Lovelace | Pharmacist | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2013-09-05 |
| 1013291608 | Tischa Becker | Pharmacist | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2011-10-01 |
| 1013224914 | Victoria Ann Fitzgerald | Pharmacist | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2010-09-13 |
| 1437205887 | Juliet V Smith-edwards | Dentist | 111 Coors Blvd Nw, E-6, Albuquerque, NM 87121-2006 | 2007-01-26 |
| 1447334008 | David Anthony Castillo | Dentist | 111 Coors Blvd Nw, E-6, Albuquerque, NM 87121-2006 | 2006-10-24 |
| 1659473429 | Bradley E Gibbs | Pharmacist | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2006-09-02 |
| 1083639611 | Smiths Food & Drug Centers Inc | Pharmacy | 111 Coors Blvd Nw, Albuquerque, NM 87121-2006 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871144196 | Mireya Molina | Technician | 2911 Cabral Trl Sw, Albuquerque, NM 87121 | 2019-09-27 |
| 1093282725 | Tomasita Sedillo | Registered Nurse | 4050 118th St Sw, Albuquerque, NM 87121 | 2018-10-31 |
| 1285112748 | Wesley Ross Hanchett | Dentist | 3715 Las Estancias Way, Suite 101, Albuquerque, NM 87121 | 2018-08-06 |
| 1699266106 | Michael Thomas Lauer | Dentist | 120 98th St Sw Suite C-3, Albuquerque, NM 87121 | 2018-05-21 |
| 1992295299 | Kimberlee Ann Dutton | Registered Nurse | 3715 Las Estancias Ct Sw, Albuquerque, NM 87121 | 2018-05-14 |
| 1376069385 | Lisa Dudasik | Day Training/Habilitation Specialist | 2300 Diamond Mesa Trail Sw, 8805, Albuquerque, NM 87121 | 2017-08-22 |
| 1497297444 | Jeffrey Romero I | Behavior Technician | 1015 Alexandra St Sw, Albuquerque, NM 87121 | 2016-11-08 |
| 1912457151 | Deamber Yonker | Technician, Other | 309 Bristol Nw, Albuquerque, NM 87121 | 2016-10-12 |
| 1457727125 | Perfect Teeth / Coors & Central P.C. | Dentist | 6660 Central Ave Sw, Albuquerque, NM 87121 | 2015-08-18 |
| 1053719344 | South Valley Children's Dentistry | Dentist | 3510 Coors Blvd., Sw, Albuquerque, NM 87121 | 2014-12-18 |
| Find all providers in zip 87121 | ||||
| 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 | 87121 |
Please comment or provide details below to improve the information on ALBUQUERQUE WEST SMILES YOUTH DENTISTRY, PC.
| 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.