# SANTA FE DENTIST OFFICE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Santa Fe Dentist Office
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982062048
- **Authorized official:** DR. KELLEY HOLLINGSWORTH RYALS DDS (OWNER DENTIST)
- **Authorized official phone:** (505) 209-9080

## Contact information

- **Practice address:** 5131 MAIN STREET, 101, SANTA FE, NM 87507
- **Practice address phone:** (505) 209-9080
- **Practice address fax:** (505) 750-9982
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (949) 474-1495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2016
- **Last updated:** 02/07/2022