Healthcare Provider Details

I. General information

NPI: 1306391081
Provider Name (Legal Business Name): SARAH ELIZABETH AGUIRRE D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 RIDGECREST DR SE
ALBUQUERQUE NM
87108-5129
US

IV. Provider business mailing address

PO BOX 90757
ALBUQUERQUE NM
87199-0757
US

V. Phone/Fax

Practice location:
  • Phone: 505-658-8236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDB-2026-0289
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: