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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: August 16, 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
Phone(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
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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 NPPES & CMS

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

What is Great White Dentistry's NPI number?

The NPI number for Great White Dentistry is 1639663792. It was assigned to this organization in the NPPES registry on June 21, 2018. The provider is doing business as Isham Dental.

Where is Great White Dentistry located?

Great White Dentistry is located at 5555 Montgomery Blvd NE Ste 17, Albuquerque, NM 87109. The listed phone number is (505) 881-0422.

What is Great White Dentistry's specialty?

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

When was this NPI record last updated?

The NPPES record for Great White Dentistry was last updated on June 21, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.