Individual provider Active NPI

John Harmon, DDS, MS

  • Endodontics
  • Rio Rancho, NM
National Provider Identifier
1285696724
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DD2741 Issued in NM
Practice address
2320 Grande Blvd SE
Suite a
Rio Rancho, NM 87124-1653
Phone
(505) 891-2100
NPI assigned
Apr 3, 2006
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DD2741 NM Primary
Endodontics 1223E0200X 0401006657 VA

Addresses

Primary practice location

2320 Grande Blvd SE
Suite a
Rio Rancho, NM 87124-1653

Mailing address

2320 Grande Blvd SE
Suite a
Rio Rancho, NM 87124-1653
Phone (505) 891-2100

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
I20151006000848 NM Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709194038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DD2741NMMDEndodontist
0401006657VAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Endodontics Endodontics Past Accepting new patients

Organizations & group practices 1

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1285696724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 GRANDE BLVD SE",
            "address_2": "SUITE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241653",
            "telephone_number": "505-891-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 GRANDE BLVD SE",
            "address_2": "SUITE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241653",
            "telephone_number": "505-891-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NM",
            "license": "DD2741",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401006657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.