Provider Demographics
NPI:1801013487
Name:NAVAJO HEALTH FOUNDATION
Entity Type:Organization
Organization Name:NAVAJO HEALTH FOUNDATION
Other - Org Name:SAGE DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDIAL STAFF CREDENTIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-755-4500
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:GANADO
Mailing Address - State:AZ
Mailing Address - Zip Code:86505-0457
Mailing Address - Country:US
Mailing Address - Phone:928-755-4500
Mailing Address - Fax:928-755-4659
Practice Address - Street 1:HIGHWAY 264 & JUNCTION 191
Practice Address - Street 2:
Practice Address - City:GANADO
Practice Address - State:AZ
Practice Address - Zip Code:86505-0457
Practice Address - Country:US
Practice Address - Phone:928-755-4500
Practice Address - Fax:928-755-4659
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAJO HEALTH FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-18
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRGH3899261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ033983Medicare Oscar/Certification