OrganizationActive
Sjt Pediatric Dentistry LLC
NPI 1154804755 · Pediatric Dentistry · Albuquerque, NM
Sjt Pediatric Dentistry LLC is a Pediatric Dentistry organization in Albuquerque, NM (NPI 1154804755).
Provider details
- NPI number
- 1154804755
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Ebonie Gonzales, Credentialing Manager(505) 850-3769
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4620 Jefferson Ln Ne Ste C
Albuquerque, NM 87109-2149
Phone: (505) 888-3520
Street-level locationGet directions
Mailing address
4620 Jefferson Ln Ne Ste C
Albuquerque, NM 87109-2149
Other names (DBA / former)
- Doing business as
- Abq Pediatric Dentistry
Registry dates
- Enumerated
- 2018-09-10
- Last updated
- 2024-03-25
- Certified
- 2024-03-25
Frequently asked questions
- What is Sjt Pediatric Dentistry LLC's NPI number?
- Sjt Pediatric Dentistry LLC's National Provider Identifier (NPI) is 1154804755, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sjt Pediatric Dentistry LLC?
- Sjt Pediatric Dentistry LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Sjt Pediatric Dentistry LLC located?
- Sjt Pediatric Dentistry LLC's practice location on file with NPPES is 4620 Jefferson Ln Ne Ste C, Albuquerque, NM 87109-2149.
- What is Sjt Pediatric Dentistry LLC's phone number?
- The practice phone number listed in the NPPES registry for Sjt Pediatric Dentistry LLC is (505) 888-3520.
- Who is the authorized official for Sjt Pediatric Dentistry LLC?
- The authorized official listed on Sjt Pediatric Dentistry LLC's NPPES record is Ebonie Gonzales, Credentialing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sjt Pediatric Dentistry LLC's NPI active?
- Yes — Sjt Pediatric Dentistry LLC's NPI (1154804755) is active in the NPPES registry as of the last update on 2024-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.