Individual provider Active NPI

Hamid Ranjbaran

  • General Practice Dentistry
  • Las Cruces, NM
National Provider Identifier
1063943793
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD4846 Issued in NM
Practice address
1405 S Valley Dr Ste 200
Las Cruces, NM 88005-3132
Phone
(575) 532-5437
NPI assigned
Mar 24, 2017
Last updated
May 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD4846 NM Primary
Student in an Organized Health Care Education/Training Program 390200000X NM

Addresses

Primary practice location

1405 S Valley Dr Ste 200
Las Cruces, NM 88005-3132

Mailing address

1405 S Valley Dr Ste 200
Las Cruces, NM 88005-3132

Other practice location 1

1 University Of New Mexico
MSC 11 6093
Albuquerque, NM 87131-0001
Phone (505) 272-5184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170731003680 NM Order and Referring Only - DentistPractitioner - Dentist 6406127018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD4846NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Dental CurrentSince Oct 16, 2022 Accepting new patients
Kidskare P.C. General Practice Past Accepting new patients
All Smiles Family Dental Clinics, LLC General Practice Past Accepting new patients

Locations

1137 Commercial Dr SE
Ste 103
Rio Rancho, NM 87124
Phone (505) 896-9399

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1063943793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 S VALLEY DR STE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S VALLEY DR STE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053132",
            "telephone_number": "575-532-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_2": "MSC 11 6093",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871310001",
            "country_code": "US",
            "telephone_number": "505-272-5184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANJBARAN",
        "first_name": "HAMID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4846",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.