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General NPI Number Information
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NPI Number | 1679561716
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Entity Type | Individual
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Provider Name | DONNA KIDBY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1442 S SAINT FRANCIS DR
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City | SANTA FE
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State | NM
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Zip | 87505-4031
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Country | US
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Telephone | 505-988-2178
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 CALLE DE SEBASTIAN
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City | SANTA FE
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State | NM
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Zip | 87505-7314
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Country | US
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Telephone | 505-983-4461
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD2274
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | DD2274
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License Number State | NM
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