Individual provider Active NPI

Kaiyra Salcido, DDS

  • Dentist
  • Silver City, NM
National Provider Identifier
1316200645
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD3663 Issued in NM
Practice address
3801 N. Pinos Altos Rd.
Silver City, NM 88061-6020
Phone
(575) 597-3801
Fax
(575) 597-6272
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD3663 NM Primary
Dentist 122300000X CS00217806 NM

Addresses

Primary practice location

3801 N. Pinos Altos Rd.
Silver City, NM 88061-6020

Mailing address

3801 N. Pinos Altos Rd.
Silver City, NM 88061-6020
Phone (575) 597-3801

Other identifiers 1

IdentifierTypeStateIssuer
02151570MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180314000579 NM Practitioner - Dentist 7113222563 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CS00217806NMMDDentist
DD3663NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ben Archer Health Center CurrentSince Feb 4, 2018 Accepting new patients
Ben Archer Health Center Current Accepting new patients
Ben Archer Health Center CurrentSince Feb 4, 2018 Accepting new patients

Locations

1960 N Date St
Truth Or Consequences, NM 87901
Phone (575) 894-7662

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1316200645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N. PINOS ALTOS RD.",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880616020",
            "telephone_number": "575-597-3801",
            "fax_number": "575-597-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N. PINOS ALTOS RD.",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880616020",
            "telephone_number": "575-597-3801",
            "fax_number": "575-597-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCIDO",
        "first_name": "KAIYRA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3663",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "CS00217806",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02151570",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.