Samuel Zachary Tanner, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

00202107 Issued in CO

Practice address

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

Phone

(970) 822-7722

Fax

(970) 822-7616

NPI assigned

Oct 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tabeguache Dental PLLC

  • Dental Clinic/Center
  • Grand Junction, CO
  • NPI 1477439198
  NPD Authorized official

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1588092738",
    "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",
            "fax_number": "970-822-7616"
        },
        {
            "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",
            "fax_number": "970-822-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "SAMUEL",
        "middle_name": "ZACHARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34705",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10592",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tail Wind Therapies PC
• Terry Lynn Talbot, R. PH.
• Jordan Tamayo
• Austin Edward Tanksley, LPN
• Nancy L. Tanner, LCSW
• Gregory Joseph Tarman, MD
• Kathryn Tarman, MD
• James Mercer Tarr, D. D. S.
• Mesha Tavill
• Jennifer Ann Taylor

• Dentist in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Dentist in Colorado

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.