Claud Mahlon Fraleigh II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2619 Issued in NM

Practice address

1960 N Date St
Truth Or Consequences, NM 87901-3701

Phone

(575) 894-7662

Fax

(575) 894-7930

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1437200284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N DATE ST",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879013701",
            "telephone_number": "575-894-7662",
            "fax_number": "575-894-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEIGH",
        "first_name": "CLAUD",
        "middle_name": "MAHLON",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "917-9300",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179300",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eunice Esparza
• Matthew H Felts, DDS
• Katrina Fernandez, LMHC
• Jocelyn Fiaschetti, LCSW
• Karen-Lynn W Fiato, CNP
• Faustino C. Froilan, MD
• Lisa Marie Gabaldon
• Ronald Gabioud
• Esther Garcia, CSW
• Judy Lynn Garcia, OTR/L

• General Practice Dentistry in Truth Or Consequences, NM
• Providers in Truth Or Consequences, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.