Chaficath Tatiana Aponte, D.D.S

Individual provider Active NPI Dentist · Gallup, NM

NPI 1376790725 · NPPES record last updated Sep 28, 2009

Key facts

NPI
1376790725
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
57324 (CA)
Practice address
516 Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1560
Fax
(505) 722-1565
NPI assigned
Aug 27, 2008
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)
Yes

State licenses

LicenseStateTypeSpecialty
63088CAMDDental Assistant
57324CAMDEmergency Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57324 CA Yes
Dental Assistant 126800000X 63088 CA

Addresses

Primary practice location

516 Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1560

Other providers in Gallup, NM

All providers in Gallup, NM · Dentist in New Mexico

Sources for this page

Verify at the official NPI Registry.