Active NPI
Gerald Frank Prohaska, DDS,MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Albuquerque, NM
National Provider Identifier
1821179508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 826
- Practice address
- 6800 Montgomery Blvd NE
Suite B
Albuquerque, NM 87109-1405 - Phone
- (505) 881-1100
- Fax
- (505) 884-2933
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 826 | NM | Primary |
Addresses
Primary practice location
6800 Montgomery Blvd NE
Suite B
Albuquerque, NM 87109-1405
Mailing address
6800 Montgomery Blvd NE
Suite B
Albuquerque, NM 87109-1405
Phone (505) 881-1100
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 826 | NM | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786233600000",
"number": "1821179508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 MONTGOMERY BLVD NE",
"address_2": "SUITE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091405",
"telephone_number": "505-881-1100",
"fax_number": "505-884-2933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 MONTGOMERY BLVD NE",
"address_2": "SUITE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091405",
"telephone_number": "505-881-1100",
"fax_number": "505-884-2933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROHASKA",
"first_name": "GERALD",
"middle_name": "FRANK",
"name_prefix": "Dr.",
"credential": "DDS,MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2026-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NM",
"license": "826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
- Carl C. Profazi, D.D.S.
- Professional Case Coordination and Consultation Inc
- Professional Case Coordination Services LLC
- Professional Wound Specialists PLLC
- Trent Lee Proffitt, M.D.
- Erica Prokopich, NP-C
- Prospera Healthcare New Mexico LLC
- Tony Jacinto Prosser, PHARMD
- Prosthetic Orthotic Specialists, Inc
- Prosthetic Orthotic Specialists, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.