Provider Demographics
NPI:1316200645
Name:SALCIDO, KAIYRA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:KAIYRA
Middle Name:
Last Name:SALCIDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 N. PINOS ALTOS RD.
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-6020
Mailing Address - Country:US
Mailing Address - Phone:575-597-3801
Mailing Address - Fax:575-597-6272
Practice Address - Street 1:3801 N. PINOS ALTOS RD.
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-6020
Practice Address - Country:US
Practice Address - Phone:575-597-3801
Practice Address - Fax:575-597-6272
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3663122300000X
NMCS00217806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM02151570Medicaid