Active NPI
Rachel Harms Fanning, DDS
- Dentist
- Albuquerque, NM
National Provider Identifier
1205064409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3429
- Practice address
- 3901 Georgia St NE
Suite C4
Albuquerque, NM 87110-1359 - Phone
- (505) 884-9798
- NPI assigned
- Jun 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD3429 | NM | Primary |
Addresses
Primary practice location
3901 Georgia St NE
Suite C4
Albuquerque, NM 87110-1359
Mailing address
5507 Eakes Rd NW
Los Ranchos, NM 87107-5529
Phone (573) 230-7237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD3429 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1205064409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5507 EAKES RD NW",
"city": "LOS RANCHOS",
"state": "NM",
"postal_code": "871075529",
"telephone_number": "573-230-7237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 GEORGIA ST NE",
"address_2": "SUITE C4",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871101359",
"telephone_number": "505-884-9798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNING",
"first_name": "RACHEL",
"middle_name": "HARMS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-25",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.