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SUNDANCE DENTAL CARE OF RIO RANCHO LLC NPI 1164725503


NPI Information

NPI: 1164725503
Provider Name: SUNDANCE DENTAL CARE OF RIO RANCHO, LLC
Classification: Dentist - 122300000X
Entity Type: Organization
Address:
770 BROADMOOR BLVD NE
RIO RANCHO, NM
ZIP 87124
Phone: (505) 891-0554
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SUNDANCE DENTAL CARE OF RIO RANCHO, LLC is a dentist in Rio Rancho, NM. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. SUNDANCE DENTAL CARE OF RIO RANCHO, LLC NPI is 1164725503. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

770 BROADMOOR BLVD NE
RIO RANCHO, NM
ZIP 87124
Phone: (505) 891-0554
Fax: (505) 891-0552

The provider's authorized official is Michelle Brown .
The authorized official title is Manager and has the following contact phone number (505) 326-6800.

The enumeration date for this NPI number is 12/7/2010 and was last updated on 6/17/2014.


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
1122300000XDentistDD2872NEW MEXICONo
2122300000XDentistDD3016NEW MEXICONo
3122300000XDentistDD2287NEW 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
11578721718MEDICAIDNEW MEXICO
21316070303MEDICAIDNEW MEXICO
31093982027MEDICAIDNEW MEXICO
41437146768MEDICAIDNEW MEXICO
51447415849MEDICAIDNEW MEXICO
61659369700MEDICAIDNEW 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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