| Dr. Dental | |
|
800 Juan Tabo Blvd Ne Ste Q Albuquerque NM 87123-1444 | |
| (505) 554-2262 | |
| (505) 554-2697 |
| Full Name | Dr. Dental |
|---|---|
| Speciality | Dentist |
| Location | 800 Juan Tabo Blvd Ne Ste Q, Albuquerque, New Mexico |
| Authorized Official Name and Position | Suneel Kumar Namburi (DENTIST) |
| Authorized Official Contact | 6307309676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Dental 800 Juan Tabo Blvd Ne Ste Q Albuquerque NM 87123-1444 Ph: (505) 554-2262 | Dr. Dental 800 Juan Tabo Blvd Ne Ste Q Albuquerque NM 87123-1444 Ph: (505) 554-2262 |
| NPI Number | 1356705305 |
|---|---|
| Provider Enumeration Date | 04/06/2016 |
| Last Update Date | 09/19/2022 |
| Medicare PECOS PAC ID | 1850833401 |
|---|---|
| Medicare Enrollment ID | O20240611001154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356705305 | NPI | - | NPPES |
| 32284756 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD4343 (New Mexico) | Primary |
| Provider Name | Suneel Kumar Namburi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1811321003 PECOS PAC ID: 6901116250 Enrollment ID: I20240611001366 |
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