NPIMap

Individual provider Active NPI

Anne Kallista Harrison, D.D.S

  • General Practice Dentistry
  • Albuquerque, NM
National Provider Identifier
1295090975
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD3696 Issued in NM
Practice address
8501 Candelaria Rd NE
Suite C1
Albuquerque, NM 87112-1034
Phone
(505) 298-9600
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD3696 NM Primary

Addresses

Primary practice location

8501 Candelaria Rd NE
Suite C1
Albuquerque, NM 87112-1034

Mailing address

1922 Rio Grande Blvd NW
Albuquerque, NM 87104-2524
Phone (505) 504-4156

Other names 1

  • Dr. Anne Kallista Johnsno Former name

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

LicenseStateTypeSpecialty
DD3696NMMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1295090975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 RIO GRANDE BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042524",
            "telephone_number": "505-504-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 CANDELARIA RD NE",
            "address_2": "SUITE C1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121034",
            "telephone_number": "505-298-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "ANNE",
        "middle_name": "KALLISTA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "JOHNSNO",
            "middle_name": "KALLISTA",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 4, 2013; 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.