Gustavo Vasquez Sida, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DD5149 Issued in NM

Practice address

1998 N Motel Blvd
Las Cruces, NM 88007

Phone

(575) 541-5941

Fax

(575) 541-5048

NPI assigned

Jun 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Truth Or Consequences, NM
  • NPI 1871528505
  Medicare reassignment NPD
• Ben Archer Health Center

  dba Ben Archer Health Center Deming School Base

  • Federally Qualified Health Center (FQHC)
  • Deming, NM
  • NPI 1194443135
  NPD
• Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1780619411
  NPD
• Cute Smiles 4 Kids

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1538314992
  NPD (past)
• Sdcaz LLC

  dba Cute Smiles 4 Kids

  • Pediatric Dentistry
  • Phoenix, AZ
  • NPI 1659175347
  NPD (past)

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1871088419",
    "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": "1998 N MOTEL BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88007",
            "telephone_number": "575-541-5941",
            "fax_number": "575-541-5048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 W Indian School Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850174035",
            "country_code": "US",
            "telephone_number": "602-861-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1819 W Dunlap Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850214375",
            "country_code": "US",
            "telephone_number": "602-861-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1819 W Dunlap Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850214375",
            "country_code": "US",
            "telephone_number": "602-861-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDA",
        "first_name": "GUSTAVO",
        "middle_name": "VASQUEZ",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010085",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thakur Shrestha, MD
• Anita Shrivastava, DO
• Eileen Shult, RN,GNP C
• Dawn Shults
• Isabelo Samson Sicsic Jr.
• Afrin Ahmed Siddiqui, DDS
• Cindi Siebe, RN LMT
• Judi Siegfried, LISW
• Sierra Family Healthcare, PC
• Silvia M Sierra Flores, MD

• Dentist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.