NPIMap

Organization Active NPI

Tasker Hatch Rowan LLC

  • Dentist
  • Los Lunas, NM
National Provider Identifier
1093071987
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD2829 Issued in NM
Legal business name
TASKER HATCH ROWAN LLC
Practice address
106 Main St NE
Los Lunas, NM 87031-7559
Phone
(505) 865-1999
Fax
(505) 899-4804
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Ebonie Gonzales
Title
Credentialing Manager
Phone
(505) 850-3769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DD2829 NM Primary

Addresses

Primary practice location

106 Main St NE
Los Lunas, NM 87031-7559

Mailing address

8201 Golf Course Rd NW Ste C3
Albuquerque, NM 87120-5805
Phone (505) 892-9010

Other identifiers 1

IdentifierTypeStateIssuer
22535268MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Tasker Hatch Rowan LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

106 Main St NE
Los Lunas, NM 87031
Phone (505) 865-1999

106 Main St NE
Ste B
Los Lunas, NM 87031

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1093071987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 GOLF COURSE RD NW STE C3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205805",
            "telephone_number": "505-892-9010",
            "fax_number": "505-899-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MAIN ST NE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317559",
            "telephone_number": "505-865-1999",
            "fax_number": "505-899-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TASKER HATCH ROWAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "EBONIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "505-850-3769"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD2829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22535268",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.