NPIMap

Individual provider Active NPI

Gary A. Meckler, DDS

  • Pediatric Dentistry
  • Albuquerque, NM
National Provider Identifier
1497745459
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DD1993 Issued in NM
Practice address
8300 Carmel Ave NE
Suite 602
Albuquerque, NM 87122-3147
Phone
(505) 878-0700
Fax
(505) 880-1020
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DD1993 NM Primary

Addresses

Primary practice location

8300 Carmel Ave NE
Suite 602
Albuquerque, NM 87122-3147

Mailing address

8300 Carmel Ave NE
Suite 602
Albuquerque, NM 87122-3147
Phone (505) 878-0700

Other identifiers 1

IdentifierTypeStateIssuer
B8319MedicaidNM

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
DD1993NMMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497745459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 CARMEL AVE NE",
            "address_2": "SUITE 602",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223147",
            "telephone_number": "505-878-0700",
            "fax_number": "505-880-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CARMEL AVE NE",
            "address_2": "SUITE 602",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871223147",
            "telephone_number": "505-878-0700",
            "fax_number": "505-880-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECKLER",
        "first_name": "GARY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DD1993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B8319",
            "state": "NM"
        }
    ],
    "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 Jul 9, 2007; 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.