Organization Active NPI

Mira Consulting, Incorporated

  • Public Health Dentistry
  • Albuquerque, NM
National Provider Identifier
1609908763
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
MIRA CONSULTING, INCORPORATED
Practice address
4100 Hawkins St NE Ste a
Albuquerque, NM 87109-4531
Phone
(505) 898-2797
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Daniel E. Mirabal
Title
Ceo
Phone
(505) 898-2797

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0001X Primary
Public Health or Welfare Agency 251K00000X

Addresses

Primary practice location

4100 Hawkins St NE Ste a
Albuquerque, NM 87109-4531

Mailing address

4100 Hawkins St NE Ste a
Albuquerque, NM 87109-4531
Phone (505) 898-2797

Other identifiers 1

IdentifierTypeStateIssuer
S2785MedicaidNM

National Provider Directory

National Provider Directory

Locations

4100 Hawkins St NE
Ste A
Albuquerque, NM 87109
Phone (505) 898-2797

6808 Academy Parkway East NE
Ste A2
Albuquerque, NM 87109

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1609908763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 HAWKINS ST NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094531",
            "telephone_number": "505-898-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 HAWKINS ST NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094531",
            "telephone_number": "505-898-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA CONSULTING, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MIRABAL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-898-2797"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S2785",
            "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 Sep 11, 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.