DR. JARED ROBERTSON D.D.S. NPI 1942565270

NPI Information

NPI: 1942565270
Provider Name: DR. JARED ROBERTSON, D.D.S.
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
PECOS Registration: Yes
Address: 10000 COORS BYP NW
SUITE G218
ALBUQUERQUE, NM
ZIP 87114
Phone: (505) 242-4867

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NPI Details

DR. Jared Robertson, D.D.S. is a general practice dentist in Albuquerque, NM. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Jared Robertson, D.D.S. NPI is 1942565270. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10000 COORS BYP NW
SUITE G218
ALBUQUERQUE, NM
ZIP 87114-040
Phone: (505) 242-4867
Fax: (505) 890-2883

The NPI 1942565270 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/12/2012 and was last updated on 7/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	DD3699	NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DD3699	OTHER	NEW MEXICO	STATE DENTAL LISENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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