Healthcare Provider Details

I. General information

NPI: 1053258699
Provider Name (Legal Business Name): ALBUQUERQUE DENTAL ARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 NIGHT WHISPER RD NW STE 100
ALBUQUERQUE NM
87114-1576
US

IV. Provider business mailing address

5740 NIGHT WHISPER RD NW STE 100
ALBUQUERQUE NM
87114-1576
US

V. Phone/Fax

Practice location:
  • Phone: 505-792-1585
  • Fax: 505-792-1587
Mailing address:
  • Phone: 505-792-1585
  • Fax: 505-792-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ABDUL AL DOORI
Title or Position: OWNER
Credential: DDS
Phone: 415-941-9244