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505 DENTAL LLC NPI 1710404504


NPI Information

NPI: 1710404504
Provider Name: 505 DENTAL LLC

Doing Business As: AMERICAN INSTITUTE OF DENTAL ASSISTING

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2901 JUAN TABO BLVD NE STE 10
ALBUQUERQUE, NM
ZIP 87112
Phone: (505) 395-6240
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505 DENTAL LLC 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. 505 DENTAL LLC NPI is 1710404504. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As American Institute Of Dental Assisting.

The provider's business location address is:

2901 JUAN TABO BLVD NE STE 10
ALBUQUERQUE, NM
ZIP 87112-885
Phone: (505) 395-6240
Fax: (505) 214-5132

The provider's authorized official is Jonah L Foutz .
The authorized official title is Owner/ceo and has the following contact phone number (505) 395-6240.

The enumeration date for this NPI number is 8/23/2017 and was last updated on 7/21/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeDDS662NEW MEXICOYes

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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