NPIMap

Organization Active NPI

Tasker Hatch Rowan LLC

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1891011052
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD3168 Issued in NM
Legal business name
TASKER HATCH ROWAN LLC
Practice address
2801 Eubank Blvd NE Ste J
Suite D2
Albuquerque, NM 87112-1300
Phone
(505) 299-9606
Fax
(505) 299-9740
NPI assigned
Apr 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Ebonie Gonzales
Title
Credentialing Manager
Phone
(505) 850-3769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DD3168 NM Primary

Addresses

Primary practice location

2801 Eubank Blvd NE Ste J
Suite D2
Albuquerque, NM 87112-1300

Mailing address

2801 Eubank Blvd NE, Ste J
Suite D2
Albuquerque, NM 87112-1034
Phone (505) 299-9606

Other identifiers 3

IdentifierTypeStateIssuer
9221857MedicaidNM
92935001MedicaidNM
9177740MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Dental Associates of NM PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2801 Eubank Blvd NE
Ste J
Albuquerque, NM 87112
Phone (505) 299-9606

2801 Eubank Blvd NE
Ste 2
Albuquerque, NM 87112
Phone (505) 299-9606

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": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1891011052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 EUBANK BLVD NE, STE J",
            "address_2": "SUITE D2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121034",
            "telephone_number": "505-299-9606",
            "fax_number": "505-299-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 EUBANK BLVD NE STE J",
            "address_2": "SUITE D2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121300",
            "telephone_number": "505-299-9606",
            "fax_number": "505-299-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TASKER HATCH ROWAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "EBONIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "505-850-3769"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9221857",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92935001",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9177740",
            "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 May 24, 2022; 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.