Healthcare Provider Details

I. General information

NPI: 1154123255
Provider Name (Legal Business Name): BONNIE LYNN RINKELS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 S ESPINA ST
LAS CRUCES NM
88003-1290
US

IV. Provider business mailing address

PO BOX 474
ORGAN NM
88052-0474
US

V. Phone/Fax

Practice location:
  • Phone: 575-496-7053
  • Fax:
Mailing address:
  • Phone: 575-496-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH3151
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: