Jared Eustaquio Salas, DDS
Individual provider Active NPI General Practice Dentistry · Cuba, NM
NPI 1649919523 · NPPES record last updated Apr 23, 2025
Key facts
- NPI
- 1649919523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DD5624 (NM)
- Practice address
- 6349 US Highway 550
Cuba, NM 87013-6032 - Phone
- (575) 289-3291
- NPI assigned
- May 31, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250408000287 | NM | Practitioner - Dentist | 1951825389 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Services | Current |
Accepting new patients | |
| Presbyterian Medical Services | General Practice | Current |
Accepting new patients |
| Presbyterian Medical Services | Current | Accepting new patients | |
| Presbyterian Medical Services | Past | Accepting new patients | |
| Aleksey Kozlov, D.M.D., LLC | Past |
Accepting new patients |
Locations
1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565
Interoperability endpoints
- jared.salasdds.p1@direct.pmsnm.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | DD5624 | NM | Yes |
Addresses
Primary practice location
6349 US Highway 550
Cuba, NM 87013-6032
Mailing address
6135 Motherwell Dr SE
Albuquerque, NM 87106-8008
Phone (505) 980-5691
Other practice location 1
2500 State Highway 197
Torreon, NM 87013
Phone (505) 731-2284
Other practice location 2
50 County Rd 13
Cuba, NM 87013-0197
Phone (575) 289-0023
Other providers in Cuba, NM
- Toni A. Price
- Pueblo Pintado Clinic
- Nikita Read
- Renal Transport Systems, Inc.
- Richard Kozoll, MD, Los Pinos Family Health
- Karolyn Jean Schaefer
- David Earl Schlottman
- Michelle Seebinger
- Tracey Simmons
- Helen Louisa Snyder
All providers in Cuba, NM · General Practice Dentistry in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.