Individual provider Active NPI

Gabriella Jaquez, RDH

  • Dental Hygienist
  • Santa Fe, NM
National Provider Identifier
1548009111
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DB-2024-0127 Issued in NM
Practice address
6401 S Richards Ave
Santa Fe, NM 87508-4887
Phone
(505) 982-4425
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DB-2024-0127 NM Primary

Addresses

Primary practice location

6401 S Richards Ave
Santa Fe, NM 87508-4887

Mailing address

78 Nash St
Rio Communities, NM 87002-6022
Phone (505) 507-3149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DB-2024-0127NMMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1548009111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 NASH ST",
            "city": "RIO COMMUNITIES",
            "state": "NM",
            "postal_code": "870026022",
            "telephone_number": "505-507-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 S RICHARDS AVE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875084887",
            "telephone_number": "505-982-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUEZ",
        "first_name": "GABRIELLA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NM",
            "license": "DB-2024-0127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.