Erica Marie Carrillo, RDH

Individual provider Active NPI Dental Hygienist · Isleta, NM

NPI 1174089692 · NPPES record last updated Feb 20, 2019

Key facts

NPI
1174089692
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
DH3227 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022-3942
Phone
(505) 869-3200
Fax
(505) 869-4881
NPI assigned
Feb 20, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DH3227NMMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH3227 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022-3942

Mailing address

PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-3200

Other providers in Isleta, NM

All providers in Isleta, NM · Dental Hygienist in New Mexico

Sources for this page

Verify at the official NPI Registry.