MEDICARE: MRS. KAIYRA SALCIDO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DD3663	NM
2	122300000X	Dentist	CS00217806	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316200645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAIYRA SALCIDO DDS

Provider Business Mailing Address
First Line	:	3801 N. PINOS ALTOS RD.
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-6020
Country	:	US
Telephone Number	:	575-597-3801
Fax Number	:	575-597-6272

Provider Business Practice Location Address
First Line	:	3801 N. PINOS ALTOS RD.
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-6020
Country	:	US
Telephone Number	:	575-597-3801
Fax Number	:	575-597-6272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	07/21/2020

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