Healthcare Provider Details

I. General information

NPI: 1730866757
Provider Name (Legal Business Name): ARASSA JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 BARBARA LOOP SE
RIO RANCHO NM
87124-1000
US

IV. Provider business mailing address

1080 ARAPAHO AVE
WORTHINGTON OH
43085-4762
US

V. Phone/Fax

Practice location:
  • Phone: 505-498-3235
  • Fax:
Mailing address:
  • Phone: 786-704-6624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30027273
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDB-2025-0404
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: