ISHAM DENTAL
NPI 1639663792
Dentist - General Practice in Albuquerque, NM

Active since June 21, 2018
5555 MONTGOMERY BLVD NE STE 17, ALBUQUERQUE, NM 87109(505) 881-0422 Get Directions Write a Review

NPPES record last updated: June 21, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Isham Dental NPPES

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

ISHAM DENTAL (NPI 1639663792) is a healthcare organization registered as a general practice in Albuquerque, New Mexico and active in the NPI registry since June 2018. The organization lists Michael Scott Isham, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1639663792
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameGREAT WHITE DENTISTRY
Location Address5555 MONTGOMERY BLVD NE STE 17Albuquerque, NM 87109-1445
Mailing Address5555 Montgomery Blvd Ne Ste 17Albuquerque, NM 87109-1445 · (505) 881-0422
Organization SubpartNo
Authorized OfficialMichael Scott IshamOwner/dentist · (505) 881-0422
Enumeration DateJune 21, 2018
NPI 1639663792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in NM · DD4733
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.

5555 MONTGOMERY BLVD NE STE 17, Albuquerque, NM 87109

Other Names 1

Doing Business AsIsham Dental

Other Identifiers 1

Medicaid48108588NM

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

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639663792, enumerated as an "organization" on June 21, 2018.

The provider is located at 5555 MONTGOMERY BLVD NE STE 17 ALBUQUERQUE, NM 87109 and the phone number is (505) 881-0422.

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

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.