100 SOUTH BLOOMFIELD PROFESSIONAL, LLC
NPI 1912519067
Dentist - General Practice in Bloomfield, NM

Q: What is 100 South Bloomfield Professional, LLC's specialty?

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

Active since August 20, 2020

100 S 1ST ST, BLOOMFIELD, NM 87413(505) 632-3344 Get Directions Write a Review

NPPES record last updated: August 20, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About 100 South Bloomfield Professional, Llc NPPES

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

100 SOUTH BLOOMFIELD PROFESSIONAL, LLC (NPI 1912519067), doing business as Sundance Dental Care Of Bloomfield, is a healthcare organization registered as a general practice in Bloomfield, New Mexico and active in the NPI registry since August 2020. The organization lists Peter Grumbos, Owner, as its authorized official.

NPPES Registry Identity

NPI1912519067

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business Name100 SOUTH BLOOMFIELD PROFESSIONAL, LLC

Location Address100 S 1ST STBloomfield, NM 87413-6242

Mailing Address100 S 1st StBloomfield, NM 87413-6242 · (505) 632-3344

Phone(505) 632-3344

Organization SubpartNo

Authorized OfficialPeter GrumbosOwner · (505) 632-3344

Enumeration DateAugust 20, 2020

NPPES CertifiedAugust 20, 2020

✔ NPI 1912519067 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.

100 S 1ST ST, Bloomfield, NM 87413

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Other Names 1

Doing Business AsSundance Dental Care Of Bloomfield

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Other Providers at the Same Location NPPES

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

DR. CHRISTOPHER D SWAGERTY DDS

Dentist (General Practice)

100 S 1ST ST
BLOOMFIELD, NM 87413

San Juan County (505) 632-3344

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 100 South Bloomfield Professional, LLC's NPI number?

The NPI number for 100 South Bloomfield Professional, LLC is 1912519067. It was assigned to this organization in the NPPES registry on August 20, 2020. The provider is doing business as Sundance Dental Care of Bloomfield.

Where is 100 South Bloomfield Professional, LLC located?

100 South Bloomfield Professional, LLC is located at 100 S 1st St, Bloomfield, NM 87413. The listed phone number is (505) 632-3344.

What is 100 South Bloomfield Professional, LLC's specialty?

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

What insurance does 100 South Bloomfield Professional, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list 100 South Bloomfield 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 100 South Bloomfield Professional, LLC was last updated on August 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.