Basic Information
Provider Information
NPI: 1386016269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARIAS
FirstName: ISABEL
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: RDH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1669
Address2:  
City: SAN LUIS
State: AZ
PostalCode: 85349
CountryCode: US
TelephoneNumber: 9287226112
FaxNumber: 9287226113
Practice Location
Address1: 1896 E. BABBITT LN.
Address2:  
City: SAN LUIS
State: AZ
PostalCode: 85349
CountryCode: US
TelephoneNumber: 9287226112
FaxNumber: 9287226113
Other Information
ProviderEnumerationDate: 10/30/2015
LastUpdateDate: 10/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
124Q00000XH02030AZY Dental ProvidersDental Hygienist 

No ID Information.


Home