Active NPI
Daisy Pacheco, RDH
- Dental Hygienist
- Espanola, NM
National Provider Identifier
1861598948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH2796
- Practice address
- 111 N Railroad Ave
Espanola, NM 87532-2627 - Phone
- (505) 587-2809
- Fax
- (505) 753-7218
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH2796 | NM | Primary |
Addresses
Primary practice location
111 N Railroad Ave
Espanola, NM 87532-2627
Mailing address
111 N Railroad Ave
Espanola, NM 87532-2627
Phone (505) 587-2809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 321831 | Other | NM | PENASCO CLINIC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DH2796 | NM | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861598948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N RAILROAD AVE",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322627",
"telephone_number": "505-587-2809",
"fax_number": "505-753-7218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N RAILROAD AVE",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322627",
"telephone_number": "505-587-2809",
"fax_number": "505-753-7218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "DAISY",
"name_prefix": "Miss",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NM",
"license": "DH2796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENASCO CLINIC",
"identifier": "321831",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.