Healthcare Provider Details

I. General information

NPI: 1538034582
Provider Name (Legal Business Name): NEW MEXICO DENTAL ARTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 ZAFARANO DR
SANTA FE NM
87507-2617
US

IV. Provider business mailing address

3530 ZAFARANO DR
SANTA FE NM
87507-2617
US

V. Phone/Fax

Practice location:
  • Phone: 415-941-9244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 RAHMAN AL DOORI
Title or Position: OWNER DENTIST
Credential: DR
Phone: 415-941-9244