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1601 2ND STREET GALLUP PROFESSIONAL, LLC
NPI 1386309870
Dentist - General Practice in Gallup, NM

Active since November 01, 2021
1601 S SECOND ST, GALLUP, NM 87301(505) 722-4422(505) 722-2060 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 1601 2nd Street Gallup Professional, Llc NPPES

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

1601 2ND STREET GALLUP PROFESSIONAL, LLC (NPI 1386309870), doing business as Sundance Dental Care Of Gallup, is a healthcare organization registered as a general practice in Gallup, New Mexico and active in the NPI registry since November 2021. The organization lists Peter Grmbos, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1386309870
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name1601 2ND STREET GALLUP PROFESSIONAL, LLC
Location Address1601 S SECOND STGallup, NM 87301-5816
Mailing Address1601 S Second StGallup, NM 87301-5816 · (505) 722-4422 · Fax (505) 722-2060
Phone(505) 722-4422
Fax(505) 722-2060
Organization SubpartNo
Authorized OfficialPeter GrmbosOwner/dentist · (505) 722-4422
Enumeration DateNovember 1, 2021
NPPES CertifiedOctober 12, 2021
✔ NPI 1386309870 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.
1601 S SECOND ST, Gallup, NM 87301
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Other Names 1

Doing Business AsSundance Dental Care Of Gallup

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 7

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

SUNDANCE DENTAL CARE OF GALLUP
Dentist (General Practice)
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422
DR. JACOB JENNINGS DDS
Dentist
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422
TRAVIS EVANS
Dentist (General Practice)
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422
DR. MICHAEL DAMIAN KING D.M.D.
Dentist (General Practice)
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (801) 580-4081
KALEB MADSEN
Dentist (General Practice)
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422
DR. TYLER WHITEHEAD DDS
Dentist (General Practice)
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422
DR. LEWIS CLARK WILDE DDS
Dentist
1601 S SECOND ST
GALLUP, NM 87301
McKinley County (505) 722-4422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 1601 2nd Street Gallup Professional, LLC's NPI number?

The NPI number for 1601 2nd Street Gallup Professional, LLC is 1386309870. It was assigned to this organization in the NPPES registry on November 1, 2021. The provider is doing business as Sundance Dental Care of Gallup.

Where is 1601 2nd Street Gallup Professional, LLC located?

1601 2nd Street Gallup Professional, LLC is located at 1601 S Second St, Gallup, NM 87301. The listed phone number is (505) 722-4422.

What is 1601 2nd Street Gallup Professional, LLC's specialty?

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

What insurance does 1601 2nd Street Gallup Professional, LLC accept?

Health plans from UnitedHealthcare list 1601 2nd Street Gallup Professional, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 1601 2nd Street Gallup Professional, LLC was last updated on November 1, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.