DR. JIM R. FUQUA (NPI# 1497848188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497848188 |
| Entity Type | Individual |
| Full Name | DR. JIM R. FUQUA |
| Credential | DDS |
| Practice Address |
Albuquerque Indian Health Service Dental Clinic 9169 Coors Road Nw Albuquerque NM 87193 |
| Mailing Address |
Po Box 411957 Melbourne FL 32941-1957 |
| Practice Telephone | 5053462306 |
| Mailing Telephone | 3216381219 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3274 | NC | Dental Providers |
| Street Address |
ALBUQUERQUE INDIAN HEALTH SERVICE DENTAL CLINIC 9169 COORS ROAD NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811105380 | Don Isaac Beaucage | Counselor | 9900 Stoughton Place Nw, Albuquerque, NM 87193 | 2007-05-18 |
| 1598768129 | Jonathan Y Chiang | Dentist | 9169 Coors Rd. Nw, Albuquerque, NM 87193 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952228 | Toshiyuki Shiina | Student in an Organized Health Care Education/Training Program | Unmh Hospital, 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-06 |
| 1215538343 | Victoria Lopez | Behavior Technician | 1015 Pinatubo Pl Nw, Albuquerque, NM 87120-2974 | 2020-11-04 |
| 1790386977 | Gina D Padilla | Home Health | 1307 San Pedro Dr Ne, Albuquerque, NM 87110-6727 | 2020-11-04 |
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1598366080 | Maya Mascarenas | Behavior Technician | 516 Madeira Dr Se Apt 3, Albuquerque, NM 87108-2971 | 2020-11-03 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1831790419 | Alisa Maria Salazar | Behavior Technician | 9610 Arvada Ave Ne, Albuquerque, NM 87112-2912 | 2020-11-02 |
| 1548861065 | Darren Anzures | Behavior Technician | 10004 Benavides Rd Sw, Albuquerque, NM 87121-8126 | 2020-11-02 |
| 1962003517 | Megan Aileen Rafferty | Counselor | 1564 Trujillo Rd. S.w., Albuquerque, NM 87105-2857 | 2020-11-02 |
| 1598366056 | Katherine Imislund-clark, Lpcc | Psychologist | 122 Girard Blvd Se Apt B, Albuquerque, NM 87106-2286 | 2020-11-02 |
| Find all providers in ALBUQUERQUE | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215339270 | Thomas Dunn | Dentist | 3710 Bosque Plz Nw, Albuquerque, NM 87120-2730 | 2014-09-22 |
| 1700153475 | Michael J Fanning | Dentist | 8212 Louisiana Blvd Ne Ste A, Albuquerque, NM 87113-2105 | 2011-11-24 |
| 1154565851 | Dana M Casaus | Dentist | 5910 Cubero Dr Ne, Suite D, Albuquerque, NM 87109-3842 | 2009-04-24 |
| 1164694287 | Cottonwood Orthodontics, PC | Dentist | 3730 Ellison Rd Nw, Suite B, Albuquerque, NM 87114-7009 | 2008-03-28 |
| 1144423211 | Jack R Ray | Dentist | 4504 4th St Nw, Albuquerque, NM 87107 | 2007-06-07 |
| 1396957460 | Randy Gail Alkire | Dentist | 12000 Holly Ave Ne, Albuquerque, NM 87122-1260 | 2007-05-03 |
| 1689798944 | Helen D Bush | Dentist | 2800-a Coors Blvd. Nw, Albuquerque, NM 87120 | 2007-03-19 |
| 1497880694 | David J Harnick | Dentist | 8631 F Golf Course, Nw, Albuquerque, NM 87114 | 2007-02-21 |
| 1629127105 | Harnick & Anderson LLP | Dentist | 7520 Montgomery Blvd Ne Bldg D9, Albuquerque, NM 87109-1533 | 2007-01-10 |
| 1891858940 | Darren Haltom | Dentist | 10433 Lagrima De Oro Rd Ne, Albuquerque, NM 87111-3727 | 2006-12-19 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87193 |
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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.