TRI DENTAL LLC NPI 1124779210

NPI Information

  • NPI: 1124779210
  • Provider Name: TRI DENTAL, LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 2345 SOUTHERN BLVD SE STE B1
    RIO RANCHO, NM
    ZIP 87124
  • Phone: (505) 892-0111

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NPI Details

TRI DENTAL, LLC is a general practice dentist in Rio Rancho, 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. TRI DENTAL, LLC NPI is 1124779210. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2345 SOUTHERN BLVD SE STE B1
RIO RANCHO, NM
ZIP 87124-761
Phone: (505) 892-0111

The provider's authorized official is Brenton Mason .
The authorized official title is Member and has the following contact phone number (505) 301-4267.

The enumeration date for this NPI number is 1/11/2022 and was last updated on 1/11/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
150284282MEDICAIDNEW 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: 11/21/2025

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