Arturo D Sisneros, DDS
Individual provider Active NPI Dentist · Penasco, NM
NPI 1679736599 · NPPES record last updated Jul 9, 2013
Key facts
- NPI
- 1679736599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD3006 (NM)
- Practice address
- State Rd. 75 #15136
El Centro Family Health Penasco Dental
Penasco, NM 87533 - Phone
- (575) 587-2809
- Fax
- (575) 587-2605
- NPI assigned
- Jul 10, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|---|
| I20160602001577 | NM | Order and Referring Only - Dentist |
1254621204 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| El Centro Family Health | Past | Accepting new patients | |
| El Centro Family Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD3006 | NM | Yes |
Addresses
Primary practice location
State Rd. 75 #15136
El Centro Family Health Penasco Dental
Penasco, NM 87533
Mailing address
PO Box 158
538 N. Paseo de Onate
Espanola, NM 87532-0158
Phone (505) 753-7218
Other providers in Penasco, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2013. 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.