<unavail> in Albuquerque, NM - Medicare Dentist

is a medicare enrolled dental clinic (Dentist) in Albuquerque, New Mexico. The current practice location for is 475 Coors Blvd Nw, Suite A, Albuquerque, New Mexico. For appointments, you can reach them via phone at (505) 208-0505. The mailing address for is 475 Coors Blvd Nw, Suite A, Albuquerque, New Mexico and phone number is (619) 548-5959.

is licensed to practice in New Mexico (license number DD4029). The clinic also participates in the medicare program and its NPI number is 1750820619. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (505) 208-0505.

Contact Information


	475 Coors Blvd Nw Suite A Albuquerque NM 87121-1425
	(505) 208-0505
	Not Available

Map and Direction

Dental Care Clinic Profile

Full Name
Speciality	Dentist
Location	475 Coors Blvd Nw, Albuquerque, New Mexico
Authorized Official Name and Position	Li Bao (DENTIST)
Authorized Official Contact	5052080505
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
475 Coors Blvd Nw Suite A Albuquerque NM 87121-1425 Ph: (619) 548-5959	475 Coors Blvd Nw Suite A Albuquerque NM 87121-1425 Ph: (505) 208-0505

NPI Details:

NPI Number	1750820619
Provider Enumeration Date	02/13/2017
Last Update Date	08/06/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	8426423336
Medicare Enrollment ID	O20230406001945

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750820619	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	DD4029 (New Mexico)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Li Bao
Provider Type	Practitioner - Oral Surgery
Provider Identifiers	NPI Number: 1730501032 PECOS PAC ID: 9335514249 Enrollment ID: I20230406002119

Reviews and Comments

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Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3610 Calle Cuervo Nw, Albuquerque, NM 87114 Phone: 505-898-1976 Fax: 505-792-0708
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- Medicare Dental Clinic in Albuquerque, NM