WESTERN DERMATOLOGY CONSULTANTS PC (NPI# 1174653299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174653299 |
| Entity Type | Organization |
| Organization Name | WESTERN DERMATOLOGY CONSULTANTS PC |
| Practice Address |
10151 Montgomery Blvd Ne Bldg. 1 Ste. A Albuquerque NM 87111-3670 |
| Mailing Address |
10151 Montgomery Ne Bldg. 1 Ste. A Albuquerque NM 87111 |
| Practice Telephone | 5058555503 |
| Mailing Telephone | 5058555503 |
| Mailing Fax Number | 5058555533 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-03-06 |
| Authorized Official Name | DR. LESLIE GLASS (PRESIDENT) |
| Authorized Official Telephone | 5058555503 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | P6441 | 05 |
| Street Address |
10151 MONTGOMERY BLVD NE BLDG. 1 STE. A |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87111-3670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174512297 | Steven Roholt | Dentist | 10151 Montgomery Blvd Ne, Suite 2-d, Albuquerque, NM 87111-3670 | 2005-10-20 |
| 1568854339 | Papworth Endodontics | Dentist | 10151 Montgomery Blvd Ne, Suite 1-c, Albuquerque, NM 87111-3670 | 2015-03-03 |
| 1205062858 | Brett Douglas Schow | Dentist | 10151 Montgomery Blvd Ne, Building 2 Suite D, Albuquerque, NM 87111-3670 | 2009-06-09 |
| 1255579264 | Travis C. Rudd | Dentist | 10151 Montgomery Blvd Ne, Suite 2d, Albuquerque, NM 87111-3670 | 2009-01-29 |
| 1063610228 | Ryan Paul Savage | Dentist | 10151 Montgomery Blvd Ne, Suite 2b, Albuquerque, NM 87111 | 2007-07-10 |
| 1508061169 | Peter Norman Smith | Psychologist | 10151 Montgomery Blvd Ne, Suite 2c, Albuquerque, NM 87111-3670 | 2007-06-15 |
| 1851450175 | Brian R Papworth | Dentist | 10151 Montgomery Blvd Ne, Suite 1-c, Albuquerque, NM 87111-3670 | 2006-12-06 |
| 1861409138 | Ricardo Munoz | Dentist | 10151 Montgomery Blvd Ne, Suite A, Albuquerque, NM 87111-3670 | 2006-08-01 |
| 1689694978 | Frank Wolfel Montoya Jr. | Dentist | 10151 Montgomery Blvd Ne, Suite B, Albuquerque, NM 87111-3670 | 2006-07-20 |
| 1427004340 | Steven B. Roholt, Dds, PC | Dentist | 10151 Montgomery Blvd Ne, Suite 2-d, Albuquerque, NM 87111-3670 | 2006-05-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417438110 | Dehlen LLC | Counselor | 11000 Spain Rd Ne, Building E, Albuquerque, NM 87111 | 2018-08-22 |
| 1003313008 | Jessika Junick | Nurse Practitioner | 3825 Eubank Blvd Ne Ste A, Albuquerque, NM 87111 | 2018-04-07 |
| 1881113454 | Hayley Aragon-bell | Day Training/Habilitation Specialist | 3732 Mount Rainier Dr. Ne, Albuquerque, NM 87111 | 2017-09-14 |
| 1750803326 | Sarah Mckenzie Ochoa | Day Training/Habilitation Specialist | 3916 Garcia St Ne, Albuquerque, NM 87111 | 2017-07-14 |
| 1285179549 | Family Dental Health Care | Dentist | 4550 Eubank Blvd, Suite 203, Albuquerque, NM 87111 | 2016-12-22 |
| 1871036202 | Shobha Jagannath | Nurse Practitioner | 10700 Academy Rd Ne Apt 216, Albuquerque, NM 87111 | 2016-12-03 |
| 1508319310 | Mariana Boitano | Licensed Practical Nurse | 5400 Gibson Blvd., Albuquerque, NM 87111 | 2016-07-28 |
| 1184011082 | Adam Halpern | Specialist/Technologist | 4204 Parsifal St, Albuquerque, NM 87111 | 2015-04-20 |
| 1083015770 | Cvs Pharmacy | Public Health or Welfare | 5516 Camino Arbustos Ne, Albuquerque, NM 87111 | 2014-09-12 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in zip 87111 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124024880 | David A. Davis | Dermatology | 6200 Uptown Blvd Ne Ste 410, Albuquerque, NM 87110-4161 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003975699 | Diane M. Reisinger | Dermatology | 2019 Galisteo St Ste N9b, Santa Fe, NM 87505 | 2006-12-08 |
| 1104378314 | Desert Mountain Skin Cancer Surgery, LLC | Dermatology | 2019 Galisteo Street, Suite N-9b, Santa Fe, NM 87505 | 2016-11-04 |
| City | ALBUQUERQUE |
| Zip Code | 87111 |
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| 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.