Healthcare Provider Details

I. General information

NPI: 1316200645
Provider Name (Legal Business Name): KAIYRA SALCIDO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 N. PINOS ALTOS RD.
SILVER CITY NM
88061-6020
US

IV. Provider business mailing address

3801 N. PINOS ALTOS RD.
SILVER CITY NM
88061-6020
US

V. Phone/Fax

Practice location:
  • Phone: 575-597-3801
  • Fax: 575-597-6272
Mailing address:
  • Phone: 575-597-3801
  • Fax: 575-597-6272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD3663
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberCS00217806
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: