Mariela Victoria Leyba, RDH

Individual provider Active NPI Dental Hygienist · Isleta, NM

NPI 1346504693 · NPPES record last updated Jul 2, 2012

Key facts

NPI
1346504693
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
DH3600 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022
Phone
(505) 238-2997
NPI assigned
Jul 2, 2012
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
DH3600NMMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH3600 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022

Mailing address

P.O Box 640
Isleta, NM 87022
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.