Strider Aragorn McCash, DDS
Individual provider Active NPI Dentist · Angel Fire, NM
NPI 1376533216 · NPPES record last updated Sep 18, 2012
Key facts
- NPI
- 1376533216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD2040 (NM)
- Practice address
- 27479 Hwy 64
Angel Fire, NM 87710 - Phone
- (575) 377-1383
- NPI assigned
- Oct 23, 2005
- 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 |
|---|---|---|---|
| DD2040 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angel Fire Family Dentistry PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD2040 | NM | Yes |
Addresses
Primary practice location
27479 Hwy 64
Angel Fire, NM 87710
Mailing address
HC 71 Box 85
Eagle Nest, NM 87718-9704
Phone (575) 377-1383
Other providers in Angel Fire, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2012. 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.