SANTA FE COMMUNITY COLLEGE DENTAL CLINIC
NPI 1790953404
Dentist - General Practice in Santa Fe, NM

Q: What is Santa Fe Community College Dental Clinic's specialty?

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

Active since February 15, 2008

6401 S RICHARDS AVE, SANTA FE, NM 87508(505) 428-1710(505) 428-1511 Get Directions Write a Review

NPPES record last updated: February 15, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Santa Fe Community College Dental Clinic NPPES

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

SANTA FE COMMUNITY COLLEGE DENTAL CLINIC (NPI 1790953404) is a healthcare organization registered as a general practice in Santa Fe, New Mexico and active in the NPI registry since February 2008. The organization lists Alfred Otero, Dentist, as its authorized official.

NPPES Registry Identity

NPI1790953404

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameSANTA FE COMMUNITY COLLEGE DENTAL CLINIC

Location Address6401 S RICHARDS AVESanta Fe, NM 87508-4887

Mailing Address6401 S Richards AveSanta Fe, NM 87508-4887 · (505) 428-1710 · Fax (505) 428-1511

Phone(505) 428-1710

Fax(505) 428-1511

Organization SubpartNo

Authorized OfficialAlfred OteroDentist · (505) 428-1710

Enumeration DateFebruary 15, 2008

✔ NPI 1790953404 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.

6401 S RICHARDS AVE, Santa Fe, NM 87508

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Other Identifiers 1

Medicaid68727NM

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 12

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

TINA ANDREA BRODERICK RDH

Dental Hygienist