Carlos Vallejo Sedillo, RDH
Individual provider Active NPI Dental Hygienist · San Felipe Pueblo, NM
NPI 1154039626 · NPPES record last updated Nov 14, 2022
Key facts
- NPI
- 1154039626
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- DH4264 (NM)
- Practice address
- 8 Cedar Road
San Felipe Pueblo, NM 87001 - Phone
- (505) 867-5025
- Fax
- (505) 771-9998
- NPI assigned
- Nov 14, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH4264 | NM | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of San Felipe | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH4264 | NM | Yes |
Addresses
Primary practice location
8 Cedar Road
San Felipe Pueblo, NM 87001
Mailing address
P.O. Box 4342
San Felipe Pueblo, NM 87001
Phone (505) 867-5025
Other providers in San Felipe Pueblo, NM
- Tana Chavez
- Marvin Jordan Godner
- Timothy Earle Moeslein
- Dana Shock
- Iris Ann Toribio
- Darlene J Valencia
All providers in San Felipe Pueblo, NM · Dental Hygienist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.