Provider Demographics
NPI:1114263266
Name:ESPINOZA, JOSELYN ILANNA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:JOSELYN
Middle Name:ILANNA
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 ALYSSA DR SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-4994
Mailing Address - Country:US
Mailing Address - Phone:240-988-2305
Mailing Address - Fax:
Practice Address - Street 1:3340 RINCONADA BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7194
Practice Address - Country:US
Practice Address - Phone:575-382-2054
Practice Address - Fax:575-382-4320
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH4090124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist