Healthcare Provider Details

I. General information

NPI: 1528072444
Provider Name (Legal Business Name): JOSE FELIU SABATINO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 160 & MP 394.3
KAYENTA AZ
86033
US

IV. Provider business mailing address

PO BOX 7302
CAROLINA PR
00986-7302
US

V. Phone/Fax

Practice location:
  • Phone: 928-697-4000
  • Fax: 928-697-4145
Mailing address:
  • Phone: 787-757-7086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1201
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: