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Organization
TOURO UNIVERSITY
Active
Organization
TOURO UNIVERSITY
Active
Other names
TOURO COLLEGE OF DENTAL MEDICINE NEW MEXICO CAMPUS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA LYNN NOVOTNY (BILLING LEAD)
(914) 374-5611
Entity
Organization
Contact information
Practice address
2425 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5129
(505) 658-8236
Mailing address
2425 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5129
(505) 658-8236
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223D0004X
Dental Anesthesiology
—
NULL
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
NULL
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
NULL
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
02/25/2025
Last updated
12/17/2025
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