Blue Sky Dental LLC
Clinic/Center, Dental in Albuquerque, NM. Organization (NPI-2).
NPI number1376149971
StatusActive
Last updated in NPPESDec 9, 2020
Details
- NPI
- 1376149971
- Entity type
- Organization (NPI-2)
- Legal business name
- Blue Sky Dental LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2020
- Certification date
- Dec 8, 2020
- Last updated
- Dec 9, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
10555 Montgomery Blvd NeAlbuquerque, NM 87111-3857
Phone 505-275-2492
Mailing address
14005 Mesita Cliff Rd NeAlbuquerque, NM 87112-6517
Phone 505-331-2945
Authorized official
Corey W Woods
Registered Agent
5053312945
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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