Provider Demographics
NPI:1063397321
Name:CORDOVA, IGNACIO RUBEN III (DDS)
Entity type:Individual
Prefix:DR
First Name:IGNACIO
Middle Name:RUBEN
Last Name:CORDOVA
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 DOVER DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-5254
Mailing Address - Country:US
Mailing Address - Phone:505-659-8941
Mailing Address - Fax:
Practice Address - Street 1:7030 HOLLY AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2676
Practice Address - Country:US
Practice Address - Phone:505-234-6351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDB-2025-01551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice