Active NPI
Harshavardhan Garla, DDS
- Dentist
- Hobbs, NM
National Provider Identifier
1245518299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3956
- Practice address
- 2400 N Grimes St Ste B8
Hobbs, NM 88240-2131 - Phone
- (575) 964-8700
- Fax
- (575) 964-8703
- NPI assigned
- Jul 25, 2011
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-028787 | IL | |
| Dentist | 122300000X | DD3956 | NM | Primary |
Addresses
Primary practice location
2400 N Grimes St Ste B8
Hobbs, NM 88240-2131
Mailing address
5017 W Steel Driver Rd
Hobbs, NM 88240-0850
Phone (660) 541-0994
Other practice location 1
316 W Scharbauer St
Hobbs, NM 88240-5132
Phone (575) 393-0323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94671583 | Medicaid | NM |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150909001276 | NM | Order and Referring Only - Oral Surgery | 6103132097 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-028787 | IL | MD | Dentist |
| DD3956 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1245518299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5017 W STEEL DRIVER RD",
"city": "HOBBS",
"state": "NM",
"postal_code": "882400850",
"telephone_number": "660-541-0994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 N GRIMES ST STE B8",
"city": "HOBBS",
"state": "NM",
"postal_code": "882402131",
"telephone_number": "575-964-8700",
"fax_number": "575-964-8703"
}
],
"practiceLocations": [
{
"address_1": "316 W Scharbauer St",
"address_purpose": "LOCATION",
"city": "Hobbs",
"state": "NM",
"postal_code": "882405132",
"country_code": "US",
"telephone_number": "575-393-0323",
"fax_number": "575-396-1454",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARLA",
"first_name": "HARSHAVARDHAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-028787",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3956",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94671583",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hobbs, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.