DENTISTRY ON ST. MICHAELS LLC NPI 1376710483

NPI Information

NPI: 1376710483
Provider Name: DENTISTRY ON ST. MICHAELS LLC

Former Legal Business Name: SANTA FE PLACE DENTAL PRACTICE LLC

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
435 SAINT MICHAELS DR STE B201
SANTA FE, NM
ZIP 87505
Phone: (505) 982-4867
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DENTISTRY ON ST. MICHAELS LLC is a dental clinic center in Santa Fe, NM. DENTISTRY ON ST. MICHAELS LLC NPI is 1376710483. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Santa Fe Place Dental Practice Llc.

The provider's business location address is:

435 SAINT MICHAELS DR STE B201
SANTA FE, NM
ZIP 87505-681
Phone: (505) 982-4867
Fax: (505) 424-8535

The provider's authorized official is Christine Garris .
The authorized official title is Senior Practice Manager and has the following contact phone number (505) 982-4867.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 4/30/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

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
1	183394	OTHER	NEW MEXICO	UNITED CONCORDIA

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

NPI Synchronization or Removal

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