Active NPI
Selene Mata, RDH
- Dental Hygienist
- Las Cruces, NM
National Provider Identifier
1245624030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 3683
- Practice address
- 385 Calle de Alegra
Building C
Las Cruces, NM 88005-3423 - Phone
- (575) 532-1933
- NPI assigned
- Mar 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 3683 | NM | Primary |
Addresses
Primary practice location
385 Calle de Alegra
Building C
Las Cruces, NM 88005-3423
Mailing address
PO Box 13725
Las Cruces, NM 88013-3725
Phone (575) 532-1933
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3683 | NM | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426723200000",
"number": "1245624030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13725",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880133725",
"telephone_number": "575-532-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 CALLE DE ALEGRA",
"address_2": "BUILDING C",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053423",
"telephone_number": "575-532-1933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA",
"first_name": "SELENE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-19",
"last_updated": "2015-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NM",
"license": "3683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.