# TOURO UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TOURO COLLEGE OF DENTAL MEDICINE NEW MEXICO CAMPUS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083411433
- **Authorized official:** ANASTASIA LYNN NOVOTNY (BILLING LEAD)
- **Authorized official phone:** (914) 374-5611

## Contact information

- **Practice address:** 2425 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5129
- **Practice address phone:** (505) 658-8236
- **Mailing address:** 2425 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-5129
- **Mailing address phone:** (505) 658-8236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223D0004X | Dental Anesthesiology | — | NULL | — |
| 1223D0004X | Dental Anesthesiology | — | — | — |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 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