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Contact Information

ADVANCED ENDODONTICS
7520 MONTGOMERY BLVD
E1
ALBUQUERQUE, NM87109
 Phone: 505-797-1212
 Fax: 505-823-1831
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for ADVANCED ENDODONTICS

NPI # 1063493427
LBN Legal business name ADVANCED ENDODONTICS
Authorized official CHARLES GOODIS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/10/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
NM License # DD1759
NM License # DD1868
NM Medicaid 004283
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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