WILDWIND DENTAL (NPI# 1629290283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629290283 |
| Entity Type | Organization |
| Organization Name | WILDWIND DENTAL |
| Other Organization Name | ELLEN BALLARD DDS |
| Practice Address |
111 Longview Drive Suite B3 Los Alamos NM 87544 |
| Mailing Address |
203 Rio Bravo Los Alamos NM 87544 |
| Practice Telephone | 5056722020 |
| Practice Fax Number | 5056722020 |
| Mailing Telephone | 5059201065 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ELLEN VANDERGUST BALLARD (PRESIDENT WILDWIND DENTAL) |
| Authorized Official Telephone | 5056722020 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 1668 | NM | Dental Providers |
| Other Name | Type Code |
|---|---|
| Ellen Ballard DDS | Doing Business As Name - Organization |
| Street Address |
111 LONGVIEW DRIVE SUITE B3 |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| 1366514861 | Corazon Behavioral Health Services Inc | Clinic/Center | 1362 C Trinity Drive, Los Alamos, NM 87544 | 2006-11-14 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518163583 | High Mesa Dental Arts | Dentist | 106a Longview Drive, Los Alamos, NM 87544-3738 | 2007-06-26 |
| 1710993639 | Lewis H Roberts | Dentist | 1247 Central Ave, Suite B, Los Alamos, NM 87544-3256 | 2006-07-31 |
| 1093706707 | Patricia Ann Roberts | Dentist | 106 Longview Dr, Los Alamos, NM 87544-3738 | 2005-11-02 |
| 1083605729 | Laura Denise Heisch | Dentist | 106 A Longview Dr, Los Alamos, NM 87544-3738 | 2005-11-02 |
| 1801095062 | Reed F Cannon | Dentist | 106 A Longview Dr, Los Alamos, NM 87544-3738 | 2007-07-17 |
| 1760696694 | Enrique Posada | Dentist | 3500 Trinity Dr, Ste.b-3, Los Alamos, NM 87544-1775 | 2007-05-10 |
| 1497863666 | Jon Ward Mcdonald | Dentist | 2101 Trinity Dr, Suite P, Los Alamos, NM 87544-4102 | 2006-08-28 |
| 1588777486 | David Roger Gartz | Dentist | 106 Longview Dr, A, Los Alamos, NM 87544-3738 | 2006-08-16 |
| 1952392672 | Roger Chadwick Gartz | Dentist | 106 A Longview Dr, Los Alamos, NM 87544-3738 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959934 | Comfortable Dentistry 4u - Cottonwood, LLC | Dentist | 3613 Nm 528 Nw Ste D, Albuquerque, NM 87114-8918 | 2020-10-15 |
| 1295347326 | Sandya Vanathi Athigaman | Dentist | 612 N Canyon St, Carlsbad, NM 88220-5842 | 2020-08-19 |
| 1932729506 | Brenda Concepcion Acosta | Dentist | Aegd-1 University of New Mexico, Albuquerque, NM 87131-0001 | 2020-04-23 |
| 1730712357 | Dental Technology Trainers LLC | Dentist | 3 Calle Del Arroyo, Placitas, NM 87043-9407 | 2020-02-21 |
| 1942833199 | Salud Dental Group Albuquerque | Dentist | 3803 Atrisco Dr Nw Ste D, Albuquerque, NM 87120-4958 | 2020-02-17 |
| 1669012241 | Lc Sleep Solutions LLC | Dentist | 2001 E Lohman Ave Ste 122, Las Cruces, NM 88001-3195 | 2020-01-10 |
| 1255987616 | Katelyn Noelle Bobbitt | Dentist | 950 Unser Blvd Se Ste 100, Rio Rancho, NM 87124-6376 | 2019-08-12 |
| 1336793892 | Lee Paige Affholter | Dentist | 6349 Us 550, Cuba, NM 87013 | 2019-08-01 |
| 1073167789 | Kathryn Susanne Wynne | Dentist | 5131 Main St Ste 101, Santa Fe, NM 87507-2682 | 2019-07-31 |
| 1033770953 | Chad Joseph Davis | Dentist | 3811 Cerrillos Rd Ste 104, Santa Fe, NM 87507-4149 | 2019-06-21 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
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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.