BEAR CANYON ORAL & FACIAL SURGERY (NPI# 1871922807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871922807 |
| Entity Type | Organization |
| Organization Name | BEAR CANYON ORAL & FACIAL SURGERY |
| Practice Address |
10151 Montgomery Ne Ste 2-d Albuquerque NM 87111 |
| Practice Telephone | 5052923400 |
| Practice Fax Number | 5052927124 |
| Mailing Telephone | 5052923400 |
| Mailing Fax Number | 5052927124 |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-12 |
| Authorized Official Name | DR. TRAVIS CHARLES RUDD (PRESIDENT) |
| Authorized Official Telephone | 5052923400 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
DD3881 | NM | Ambulatory Health Care Facilities |
| Street Address |
10151 MONTGOMERY NE STE 2-D |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104468602 | Presbyterian Hospital Asc | Clinic/Center | 201 Cedar St Se Ste 7650, Albuquerque, NM 87106-4911 | 2019-10-16 |
| 1629615851 | Southwest Oral and Maxillofacial Surgeons LLC | Clinic/Center | 5900 Cubero Dr Ne Ste A, Albuquerque, NM 87109-3879 | 2019-12-06 |
| 1699159053 | Mvi Surgery Center,llc | Clinic/Center | 1720 Wyoming Blvd Ne, Albuquerque, NM 87112-3855 | 2015-07-16 |
| 1881089894 | Sandia Surgery Center LLC | Clinic/Center | 5203 Juan Tabo Blvd Ne, Suite 1e, Albuquerque, NM 87111-2683 | 2015-04-06 |
| 1932536067 | Acute Care Surgery Medical Group of New Mexico, Inc. | Clinic/Center | 4221 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 | 2013-10-03 |
| 1639456973 | Physician Surgery Center of Albuquerque LLC | Clinic/Center | 9551 Paseo Del Norte Ne, Albuquerque, NM 87122-2975 | 2011-11-15 |
| 1962685834 | Optumcare Endoscopy Center New Mexico, LLC | Clinic/Center | 5400 Gibson Blvd Se, Floor 2; Elevator C, Albuquerque, NM 87108-4729 | 2007-12-13 |
| 1184753568 | Eisbach Facial Plastic Surgery PC | Clinic/Center | 7800 Constitution Ave Ne, Albuquerque, NM 87110-7552 | 2007-03-03 |
| 1831109560 | New Mexico Orthopaedic Surgery Center, LLC | Clinic/Center | 201 Cedar St Se, Ste 7650, Albuquerque, NM 87106-4917 | 2006-08-08 |
| 1871538694 | Southwest Endoscopy Ltd | Clinic/Center | 7788 Jefferson St Ne, Albuquerque, NM 87109-4342 | 2006-06-17 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87111 |
Please comment or provide details below to improve the information on BEAR CANYON ORAL & FACIAL SURGERY.
| 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.