Provider Type Icon

LAS ESTANCIAS DENTAL GROUP PROFESSIONAL CORPORATION NPI 1639537533


NPI Information

NPI: 1639537533
Provider Name: LAS ESTANCIAS DENTAL GROUP, PROFESSIONAL CORPORATION

Doing Business As: LAS ESTANCIAS DENTAL GROUP

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 32D2121779

Address:
3715 LAS ESTANCIAS WAY SW
101
ALBUQUERQUE, NM
ZIP 87121
Phone: (505) 209-9081
Get Directions

LAS ESTANCIAS DENTAL GROUP, PROFESSIONAL CORPORATION is a general practice dentist in Albuquerque, 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. LAS ESTANCIAS DENTAL GROUP, PROFESSIONAL CORPORATION NPI is 1639537533. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Las Estancias Dental Group.

The provider's business location address is:

3715 LAS ESTANCIAS WAY SW
101
ALBUQUERQUE, NM
ZIP 87121-506
Phone: (505) 209-9081
Fax: (505) 792-6111

The provider's authorized official is Mario Herrejon-ruiz .
The authorized official title is Owner Dentist and has the following contact phone number (505) 209-9081.

The CLIA number assigned to this NPI record is 32D2121779 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/5/2016 and was last updated on 2/5/2016.


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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.