Provider Demographics
NPI:1568707479
Name:GILBERT, SASHA A (RDH, MPH)
Entity Type:Individual
Prefix:MRS
First Name:SASHA
Middle Name:A
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RDH, MPH
Other - Prefix:
Other - First Name:SASHA
Other - Middle Name:A
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:ROUTE 301 N 21 B AVE ZUNI IHS
Mailing Address - City:ZUNI
Mailing Address - State:NM
Mailing Address - Zip Code:87327
Mailing Address - Country:US
Mailing Address - Phone:505-782-4431
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 301 N 21 B AVE
Practice Address - Street 2:ZUNI IHS
Practice Address - City:ZUNI
Practice Address - State:NM
Practice Address - Zip Code:87327
Practice Address - Country:US
Practice Address - Phone:505-782-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH2217124Q00000X
CODH000904313124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist