Dawit Kidane, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PC00000228 Issued in NM

Practice address

4610 Jefferson LN NE
Albuquerque, NM 87109-2117

Phone

(505) 559-4495

Fax

(505) 842-8025

NPI assigned

Mar 2, 2021

Last updated

Mar 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Women's Cancer and Surgical Care PC

  • Gynecologic Oncology Physician
  • Albuquerque, NM
  • NPI 1871728840
  NPD
• Albuquerque Dermatology Associates, PA

  • Dermatology Physician
  • Albuquerque, NM
  • NPI 1821045329
  NPD (past)

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1619562675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7004 LORETE RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143458",
            "telephone_number": "505-610-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 JEFFERSON LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092117",
            "telephone_number": "505-559-4495",
            "fax_number": "505-842-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDANE",
        "first_name": "DAWIT",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NM",
            "license": "PC00000228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keivon Kianfar, PA-C
• Arnold John Kiburz, MD
• Shawna Avila Kibuta, MS, LMHC
• Kid's Choice Dental, Inc (Family Choice Dental)
• Kid's Choice Dental, Inc (Family Choice Dental)
• Darcie Kidder
• Kiddos ABA NM LLC
• Kidney Specialists of New Mexico, P.C.
• Kidpower Therapy Associates
• Kids First Therapy New Mexico LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.