NPIMap

Organization Active NPI

Tabeguache Dental PLLC

  • Dental Clinic/Center
  • Grand Junction, CO
National Provider Identifier
1477439198
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TABEGUACHE DENTAL PLLC
Practice address
604 25 Rd Ste B
Grand Junction, CO 81505-1202
Phone
(970) 822-7722
NPI assigned
Aug 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Dr. Samuel Zachary Tanner, DDSNPI 1588092738
Title
Manager
Phone
(480) 695-1673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

604 25 Rd Ste B
Grand Junction, CO 81505-1202

Mailing address

604 25 Rd Ste B
Grand Junction, CO 81505-1202
Phone (970) 822-7722

National Provider Directory

National Provider Directory

Locations

604 25 Rd
Ste B
Grand Junction, CO 81505
Phone (970) 822-7722

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1477439198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 25 RD STE B",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051202",
            "telephone_number": "970-822-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 25 RD STE B",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051202",
            "telephone_number": "970-822-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABEGUACHE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "ZACHARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-695-1673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.