SUMMIT FAMILY DENTAL OF FARMINGTON, LLC (NPI# 1427320654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427320654 |
| Entity Type | Organization |
| Organization Name | SUMMIT FAMILY DENTAL OF FARMINGTON, LLC |
| Practice Address |
800 E 30th St Bldg 3 Farmington NM 87401-9407 |
| Mailing Address |
6588 E Main Street Farmington NM 87402-5122 |
| Practice Telephone | 5053279161 |
| Mailing Telephone | 5053266800 |
| Mailing Fax Number | 5053266820 |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | LISA HODGES (OPERATIONS DIRECTOR) |
| Authorized Official Telephone | 5057872965 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
CS00213848 | NM | Dental Providers |
| Street Address |
800 E 30TH ST BLDG 3 |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571587 | Kyra Vanden Broeck | Dentist | 800 E 30th St Bldg 3, Farmington, NM 87401-9407 | 2020-09-07 |
| 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 | 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 |
|---|---|---|---|---|
| 1407416977 | Alexander Michael Shore | Dentist | 33153 Maplenut St, Farmington, MI 48336-4438 | 2019-06-17 |
| 1629596705 | Dds Catalyst Farmington, LLC | Dentist | 3501 N Butler Ave Ste 104, Farmington, NM 87401-6430 | 2017-09-08 |
| 1750802997 | Ryan Michael Holbrook | Dentist | 640 W Karsch Blvd, Farmington, MO 63640-3342 | 2017-06-28 |
| 1770939613 | Modern Dental Professionals, Mn PC | Dentist | 20700 Chippendale Ave W, Suite 10, Farmington, MN 55024-8207 | 2016-05-10 |
| 1508232992 | Christopher Nicholaus Roclevitch | Dentist | 3030 E Main St, T-1, Farmington, NM 87402-7636 | 2015-08-19 |
| 1003200569 | Pure Dental PC | Dentist | 2 Forest Park Dr Ste 1, Farmington, CT 06032-1446 | 2015-03-23 |
| 1417346016 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 520 W. Pine Street, Farmington, MO 63640-1426 | 2015-01-20 |
| 1487913869 | Modern Dental Professionals Utah, PC | Dentist | 280 N Union Ave, #l110, Farmington, UT 84025 | 2012-05-07 |
| 1851679393 | Peter Urling | Dentist | 19 S. Franklin St., Farmington, MO 63640 | 2011-08-02 |
| 1437443280 | Yuriy May | Dentist | 10 Birdseye Rd Ste 240, Farmington, CT 06032-2489 | 2011-06-08 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
Please comment or provide details below to improve the information on SUMMIT FAMILY DENTAL OF FARMINGTON, LLC.
| 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.