1659822062 NPI number — GEORGE W. HARPER D.D.S., PC

Table of content: (NPI 1659822062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659822062 NPI number — GEORGE W. HARPER D.D.S., PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEORGE W. HARPER D.D.S., PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659822062
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
918 PINEHURST RD. SE
Provider Second Line Business Mailing Address:
STE-103
Provider Business Mailing Address City Name:
RIO RANCHO
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-896-3600
Provider Business Mailing Address Fax Number:
505-896-3690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
918 PINEHURST RD SE
Provider Second Line Business Practice Location Address:
STE-103
Provider Business Practice Location Address City Name:
RIO RANCHO
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87124-2568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-896-3600
Provider Business Practice Location Address Fax Number:
505-896-3690
Provider Enumeration Date:
10/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
HARPER
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
505-896-3600

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DD3164 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10572856 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com