ENCHANTED HILLS DENTISTRY, PROFESSIONAL CORPORATION (NPI# 1396138038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396138038 |
| Entity Type | Organization |
| Organization Name | ENCHANTED HILLS DENTISTRY, PROFESSIONAL CORPORATION |
| Other Organization Name | ENCHANTED HILLS DENTISTRY |
| Practice Address |
470 New Mexico 528 A Bernalillo NM 87004 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 5058678444 |
| Practice Fax Number | 5058673186 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-31 |
| Authorized Official Name | MARIO HERREJON-RUIZ (OWNER DOCTOR) |
| Authorized Official Telephone | 5058678444 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Enchanted Hills Dentistry | Doing Business As Name - Organization |
| Street Address |
470 NEW MEXICO 528 A |
| City | BERNALILLO |
| State | NM |
| Zip Code | 87004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912557729 | Mary Webster Birch | Technician | 306 Riesling Rd, Bernalillo, NM 87004 | 2019-09-13 |
| 1992364483 | Vineeta Kannan | Pharmacist | 203 Sandia Day School Rd., Bernalillo, NM 87004 | 2019-06-10 |
| 1003339748 | Bryanna M Vaio | Pharmacist | 460 Nm Hwy 528, Bernalillo, NM 87004 | 2017-07-25 |
| 1033668843 | Charlotte Branson | Registered Nurse | 301 Calle De Escuela, Bernalillo, NM 87004 | 2016-09-22 |
| 1740737394 | Karin Ludi | Registered Nurse | 148 Spartan Alley, Bernalillo, NM 87004 | 2016-09-01 |
| 1356729214 | Mirey Hernandez | Case Manager/Care Coordinator | 255a Carino Del Pueblo, Bernalillo, NM 87004 | 2015-05-12 |
| 1912319609 | Tate Rubinstein | Acupuncturist | 438 S. Camino Del Pueblo, Bernalillo, NM 87004 | 2014-05-29 |
| 1083043400 | Maria De Lourdes M. Grafe | Case Manager/Care Coordinator | 255-a Camino Del Pueblo, Bernalillo, NM 87004 | 2013-11-06 |
| 1932548799 | Bryan Graziano | Dentist | 470 Pat D'arco Hwy, Unit A, Bernalillo, NM 87004 | 2013-06-14 |
| 1356699474 | Katie Elson-romero | Student in an Organized Health Care Education/Training Program | 224 N. Camino Del Pueblo, Bernalillo, NM 87004 | 2012-08-21 |
| Find all providers in zip 87004 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174992564 | Cdb 550 LLC | Dentist | 120 E Highway 550, Bernalillo, NM 87004-5967 | 2015-09-16 |
| 1932548799 | Bryan Graziano | Dentist | 470 Pat D'arco Hwy, Unit A, Bernalillo, NM 87004 | 2013-06-14 |
| 1356334189 | Phillip Sanchez | Dentist | 510 Nm 528, Suite I, Bernalillo, NM 87004 | 2005-08-26 |
| 1992035224 | Perfect Teeth / Venada Plaza P.C. | Dentist | 510 Nm 528, Suite I, Bernalillo, NM 87004 | 2010-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803830 | Tri Dental, LLC | Dentist | 3715 Las Estancias Ct Sw Ste 101, Albuquerque, NM 87121-5506 | 2020-08-28 |
| 1609485077 | Joseph Potter | Dentist | 3510 Coors Blvd Sw, Albuquerque, NM 87121-5328 | 2020-07-30 |
| 1760090880 | Elizabeth Hays | Dentist | 1405 S Valley Dr Ste 300, Las Cruces, NM 88005-3132 | 2020-07-15 |
| 1861024861 | Brian K Dennis Dds PC | Dentist | 8400 Osuna Rd Ne Ste 6a, Albuquerque, NM 87111-2073 | 2020-02-07 |
| 1285264242 | Professional Dental Care Pllc | Dentist | 550 Saint Michaels Dr Ste 2, Santa Fe, NM 87505-7604 | 2020-01-18 |
| 1134769235 | Abq Dentists PC | Dentist | 3900 Eubank Blvd Ne Ste 14, Albuquerque, NM 87111-3427 | 2020-01-07 |
| 1477197804 | Juan Tabo Dentistry LLC | Dentist | 1924 Juan Tabo Blvd Ne Ste C, Albuquerque, NM 87112-3358 | 2019-10-29 |
| 1013550094 | Bosque Smiles Dentistry, LLC | Dentist | 5600 Coors Blvd Nw Ste G4, Albuquerque, NM 87120-1877 | 2019-10-23 |
| 1336796473 | Salud Dental Group Chaparral | Dentist | 320 Mccombs Rd Ste E, Chaparral, NM 88081-7937 | 2019-08-22 |
| 1639725732 | John Jerome Fagel | Dentist | 07 Choos Gai Dr, Tohatchi, NM 87325 | 2019-08-14 |
| Find all providers with the same taxonomy | ||||
| City | BERNALILLO |
| Zip Code | 87004 |
Please comment or provide details below to improve the information on ENCHANTED HILLS DENTISTRY, PROFESSIONAL CORPORATION.
| 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.