FORT WINGATE DENTAL CLINIC
NPI 1952505208
Clinic/Center - Dental in Ft . Wingate, NM
NPI Status: Active since June 12, 2007
Contact Information
520 B SHUSH DRIVE
EXIT 33 STATE ROAD 400
FT . WINGATE, NM
ZIP 87316
Phone: (505) 722-1770
Fax: (505) 722-1796
- Organization
- Clinic/Center
- Dental
- CLIA Number: 32D0536068
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 01-02-2027
About FORT WINGATE DENTAL CLINIC
This page provides the complete NPI Profile along with additional information for Fort Wingate Dental Clinic, a provider established in Ft . Wingate, New Mexico operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1952505208 assigned on June 2007. The practitioner's primary taxonomy code is 261QD0000X with license number 9435 (). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Fort Wingate Dental Clinic. The authorized official of this NPI record is Bennie C. Yazzie (Acting Ceo)
- NPI
- 1952505208
- Provider Legal Name
- GALLUP INDIAN MEDICAL CENTER
- Other Organization Name
- FORT WINGATE DENTAL CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 520 B SHUSH DRIVE EXIT 33 STATE ROAD 400 FT . WINGATE, NM 87316
- Location Phone
- (505) 722-1770
- Location Fax
- (505) 722-1796
- Mailing Address
- 516 E. NIZHONI BLVD GALLUP, NM 87301
- Mailing Phone
- (505) 722-1770
- Mailing Fax
- (505) 722-1796
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-12-2007
- Last Update Date
- 07-22-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 9435
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 27603725 | MEDICAID (05) | NM |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 32D0536068
- Facility Type
- Hospital
- Certificate Effective Date
- January 03, 2025
- Certificate Expiration Date
- January 02, 2027
- Laboratory Director
- GEORGE BRASINIKAS MD
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Fort Wingate Dental Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1952505208, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 42. The final step is to find the difference between that total and the next multiple of ten (50 - 42 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 42 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1952505208, enumerated as an "organization" on June 12, 2007.
The provider is located at 520 B SHUSH DRIVE EXIT 33 STATE ROAD 400 FT . WINGATE, NM 87316 and the phone number is (505) 722-1770.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
