6588 EAST MAIN FARMINGTON LLC
NPI 1154934818
Dentist - General Practice in Farmington, NM

Q: What is 6588 East Main Farmington LLC's NPI number?

The NPI number for 6588 East Main Farmington LLC is 1154934818. It was assigned to this organization in the NPPES registry on August 24, 2020. The provider is doing business as Sundance Dental of Country Club.

Q: What is 6588 East Main Farmington LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since August 24, 2020

6588 E MAIN ST, FARMINGTON, NM 87402(505) 326-6800(505) 326-6820 Get Directions Write a Review

NPPES record last updated: August 24, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About 6588 East Main Farmington Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

6588 EAST MAIN FARMINGTON LLC (NPI 1154934818), doing business as Sundance Dental Of Country Club, is a healthcare organization registered as a general practice in Farmington, New Mexico and active in the NPI registry since August 2020. The organization lists Pam Draper, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1154934818

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business Name6588 EAST MAIN FARMINGTON LLC

Location Address6588 E MAIN STFarmington, NM 87402-5122

Mailing Address6588 E Main StFarmington, NM 87402-5122 · (505) 326-6800 · Fax (505) 326-6820

Phone(505) 326-6800

Fax(505) 326-6820

Organization SubpartNo

Authorized OfficialPam DraperOffice Manager · (505) 326-6800

Enumeration DateAugust 24, 2020

NPPES CertifiedAugust 24, 2020

✔ NPI 1154934818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

6588 E MAIN ST, Farmington, NM 87402

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Other Names 1

Doing Business AsSundance Dental Of Country Club

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL LYNN MANKOWITZ

Dentist