Individual provider Active NPI

Mary Kyung Jin Dalsin, LMT

  • Massage Therapist
  • Santa Fe, NM
National Provider Identifier
1063921757
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
8657 Issued in NM
Practice address
2019 Galisteo St Ste H2
Santa Fe, NM 87505-2106
Phone
(505) 557-6140
NPI assigned
Sep 25, 2017
Last updated
Sep 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 8657 NM Primary

Addresses

Primary practice location

2019 Galisteo St Ste H2
Santa Fe, NM 87505-2106

Mailing address

100 Rio Vista PL
103
Santa Fe, NM 87501-1563
Phone (505) 629-9498

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

State licenses

LicenseStateTypeSpecialty
8657NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Age to Age Counseling PC PastSince Apr 13, 2026 Accepting new patients
Northern New Mexico Health Care, LLC PastSince Mar 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1063921757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIO VISTA PL",
            "address_2": "103",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011563",
            "telephone_number": "505-629-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST STE H2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052106",
            "telephone_number": "505-557-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALSIN",
        "first_name": "MARY",
        "middle_name": "KYUNG JIN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "8657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.