Provider Demographics
NPI:1619604006
Name:ALOJADO, SANDRA KAY
Entity Type:Individual
Prefix:
First Name:SANDRA KAY
Middle Name:
Last Name:ALOJADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6128 S VIA DEL AQUA DR
Mailing Address - Street 2:
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-7006
Mailing Address - Country:US
Mailing Address - Phone:972-621-9754
Mailing Address - Fax:
Practice Address - Street 1:1501 E CAMP MOHAVE RD # 1
Practice Address - Street 2:
Practice Address - City:FORT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-9406
Practice Address - Country:US
Practice Address - Phone:928-758-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011536122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist