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Provider Information for 1528086188

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. JOHN DAVID NOYES JR. DDS

Gender: MALE

Individual NPI: 1528086188

Calendar   Last Updated:  2020-07-29
  Certification Date:  2020-07-29

Details

Name Value
NPI 1528086188
Enumeration Date 2006-07-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 120 98TH ST NW STE C3
ALBUQUERQUE, NM 87121-9021
United States

Phone: 505-352-5439 | Fax:
View Map External Link
Primary Practice Address 120 98TH ST NW STE C3
ALBUQUERQUE, NM 87121-9021
United States

Phone: 510-701-5076 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NM 51004844
Other UNITED CONCORDIA GROUP # NM 1768244
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist NM DD2523