MEDICARE: CASEY ALLMAN DMD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1154120277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASEY ALLMAN DMD LLC

Provider Business Mailing Address
First Line	:	5740 NIGHT WHISPER RD NW STE 100
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-1576
Country	:	US
Telephone Number	:	505-803-8187
Fax Number	:	505-792-1587

Provider Business Practice Location Address
First Line	:	5740 NIGHT WHISPER RD NW STE 100
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-1576
Country	:	US
Telephone Number	:	505-792-1585
Fax Number	:	505-792-1587

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CASEY C ALLMAN
Credential	:	DMD
Telephone Number	:	505-792-1585

Provider Enumeration Date	:	03/11/2025
Last Update Date	:	03/11/2025

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