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ADVANCED ENDODONTICS NPI 1063493427


NPI Information

NPI: 1063493427
Provider Name: ADVANCED ENDODONTICS
Classification: Dentist - 1223E0200X
Entity Type: Organization

Specialization: Endodontics

Address:
7520 MONTGOMERY BLVD
E1
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 797-1212
Get Directions

ADVANCED ENDODONTICS is an endodontics dentist in Albuquerque, NM. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. ADVANCED ENDODONTICS NPI is 1063493427. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

7520 MONTGOMERY BLVD
E1
ALBUQUERQUE, NM
ZIP 87109
Phone: (505) 797-1212
Fax: (505) 823-1831

The provider's authorized official is Charles James Goodis .
The authorized official title is Owner and has the following contact phone number (505) 797-1212.

The enumeration date for this NPI number is 11/10/2005 and was last updated on 8/22/2020.


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
11223E0200XDentistEndodonticsDD1759NEW MEXICONo
21223E0200XDentistEndodonticsDD1868NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004283MEDICAIDNEW MEXICO

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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