Provider Demographics
NPI:1376790725
Name:APONTE, CHAFICATH TATIANA (DDS)
Entity Type:Individual
Prefix:
First Name:CHAFICATH
Middle Name:TATIANA
Last Name:APONTE
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:P.O. BOX 1337
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-1337
Mailing Address - Country:US
Mailing Address - Phone:505-722-1560
Mailing Address - Fax:505-722-1565
Practice Address - Street 1:516 NIZHONI BLVD
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5748
Practice Address - Country:US
Practice Address - Phone:505-722-1560
Practice Address - Fax:505-722-1565
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57324122300000X
CA63088126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No126800000XDental ProvidersDental Assistant