ABQ MODERN DENTAL GROUP
NPI 1326429622
Dentist - General Practice in Albuquerque, NM

Active since June 11, 2015
12611 MONTGOMERY BLVD NE, A-1, ALBUQUERQUE, NM 87111(505) 323-1004(505) 323-4355 Get Directions Write a Review

NPPES record last updated: June 11, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist
  • General Practice

About ABQ MODERN DENTAL GROUP

This page provides the complete NPI Profile along with additional information for Abq Modern Dental Group, a provider established in Albuquerque, New Mexico operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1326429622 assigned on June 2015. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 11 years ago. Abq Modern Dental Group operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Abq Modern Dental Group. The authorized official of this NPI record is Kelley Hollingsworth Ryals Dds (Owner Dentist)

NPI
1326429622 Verify this NPI
Provider Legal Name
ABQ MODERN DENTAL GROUP, LLC
Other Organization Name
ABQ MODERN DENTAL GROUP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12611 MONTGOMERY BLVD NE A-1 ALBUQUERQUE, NM 87111
Location Phone
(505) 323-1004
Location Fax
(505) 323-4355
Mailing Address
17000 RED HILL AVE IRVINE, CA 92614
Mailing Phone
(714) 845-8890
Mailing Fax
(949) 474-1495
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-11-2015
Last Update Date
06-11-2015
Code Navigator

A dentist like Abq Modern Dental Group is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KELLEY HOLLINGSWORTH RYALS DDS

Authorized Official Title
OWNER DENTIST
Authorized Official Phone
(505) 323-1004

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Dentist (Periodontics)
12611 MONTGOMERY BLVD NE, SUITE A-1
ALBUQUERQUE, NM 87111

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326429622, enumerated as an "organization" on June 11, 2015.

The provider is located at 12611 MONTGOMERY BLVD NE A-1 ALBUQUERQUE, NM 87111 and the phone number is (505) 323-1004.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.