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NORTHRISE DENTAL LLC NPI 1437622503


NPI Information

NPI: 1437622503
Provider Name: NORTHRISE DENTAL LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 32D2201352

Address:
2540 N TELSHOR BLVD STE E
LAS CRUCES, NM
ZIP 88011
Phone: (575) 521-9375
Get Directions

NORTHRISE DENTAL LLC is a general practice dentist in Las Cruces, NM. The provider is 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. NORTHRISE DENTAL LLC NPI is 1437622503. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2540 N TELSHOR BLVD STE E
LAS CRUCES, NM
ZIP 88011-201
Phone: (575) 521-9375
Fax: (575) 521-2637

The provider's authorized official is Jared Wallis .
The authorized official title is Dentist/owner and has the following contact phone number (575) 521-9375.

The CLIA number assigned to this NPI record is 32D2201352 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2019 and was last updated on 1/10/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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