DAVID CUNDICK (NPI# 1164737102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164737102 |
| Entity Type | Individual |
| Full Name | DAVID CUNDICK |
| Credential | DDS |
| Practice Address |
1700 N Butler Ave Farmington NM 87401-6331 |
| Practice Telephone | 5053338635 |
| Practice Fax Number | 5052584909 |
| Mailing Telephone | 5053338635 |
| Mailing Fax Number | 5052584909 |
| Enumeration Date | 2010-08-14 |
| Last Update Date | 2015-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DD4059 | NM | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 27077748 | 05 |
| Street Address |
1700 N BUTLER AVE |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-6331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073844221 | Dr. Jack Smalley D.d.s. | Dentist | 1700 N Butler Ave, Farmington, NM 87401-6331 | 2010-01-27 |
| 1104228329 | San Juan Oral & Facial Surgery | Dentist | 1700 N Butler Ave, Farmington, NM 87401-6331 | 2014-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578969754 | Simply Dental & Oral Surgery PC | Dentist | 4760 N Butler Ave Ste B1, Farmington, NM 87401-0816 | 2014-11-14 |
| 1881034262 | Christy Lottinger | Dentist | 263 Farmington Ave # Mc1710, Farmington, CT 06030-1267 | 2013-06-28 |
| 1134396567 | John J Mcneill | Dentist | 2401 E 30th St Bldg 2, Farmington, NM 87401-8986 | 2008-05-14 |
| 1841354438 | Donald A. Rice | Dentist | 2566 Oakbriar Ln, Farmington, MO 63640-7135 | 2006-12-20 |
| 1801963939 | Farmington Oral & Maxillofacial Surgical Clinic | Dentist | 20 Cr 6070, Farmington, NM 87401 | 2006-11-30 |
| 1922011378 | John A Ellis | Dentist | 444 Wilton Rd, Farmington, ME 04938-6135 | 2006-08-15 |
| 1285651133 | Connecticut Maxillofacial Surgeons, LLC | Dentist | 291 Farmington Ave, Farmington, CT 06032-1925 | 2006-07-16 |
| 1710972567 | John Mcneill Dds PC | Dentist | 2401 E 30th St, Bldg 2, Farmington, NM 87401-8986 | 2005-09-19 |
| 1881183721 | University Dentists | Dentist | 263 Farmington Ave, Farmington, CT 06030-0001 | 2018-05-07 |
| 1104228329 | San Juan Oral & Facial Surgery | Dentist | 1700 N Butler Ave, Farmington, NM 87401-6331 | 2014-09-18 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
Please comment or provide details below to improve the information on DAVID CUNDICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.