Galen Detrik Hartenberger, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD3909 Issued in NM

Practice address

200 Manzanares Ave E
Socorro, NM 87801-4215

Phone

(575) 835-3662

NPI assigned

Jul 9, 2013

Last updated

Jul 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• On the Cusp Dental Studio, LLC

  • Dentist
  • Socorro, NM
  • NPI 1457278640
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1003257981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 HOMESTEADS RD",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870439230",
            "telephone_number": "505-331-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MANZANARES AVE E",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014215",
            "telephone_number": "575-835-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTENBERGER",
        "first_name": "GALEN",
        "middle_name": "DETRIK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Sue Hancock, FNP
• Terry Wayne Hancock, MSN, RN,BC FNP
• George Hanna, DMD
• Matthew Harbuck, CCSW
• Julia Hardin
• Alexis Henderson
• Jose Delfin Herrera Jr., PCO
• Johannes Jacobus Heynekamp, MD
• Holly A Hobaugh, LMT
• David M Hochhauser, MD

• General Practice Dentistry in Socorro, NM
• Providers in Socorro, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.