MARIO FRAGOSO (NPI# 1770584369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770584369 |
| Entity Type | Individual |
| Full Name | MARIO FRAGOSO |
| Credential | DDS |
| Practice Address |
1100 F Ave Douglas AZ 85607-1919 |
| Mailing Address |
1205 F Avenue Douglas AZ 85607 |
| Practice Telephone | 5203641429 |
| Practice Fax Number | 5203644261 |
| Mailing Telephone | 5203641429 |
| Mailing Fax Number | 5203644261 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2013-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D4412 | AZ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 156069 | 05 |
| Street Address |
1100 F AVE |
| City | DOUGLAS |
| State | AZ |
| Zip Code | 85607-1919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982103479 | Heidy H Anway | Dental Hygienist | 1100 F Ave, Douglas, AZ 85607-1919 | 2018-02-09 |
| 1598276834 | Ninive Alejandra Quijada | Dental Hygienist | 1100 F Ave, Douglas, AZ 85607-1919 | 2017-10-13 |
| 1174072326 | Pamela Oliphant | Dietitian, Registered | 1100 F Ave, Douglas, AZ 85607-1919 | 2016-09-29 |
| 1851751143 | Sarah Elizabeth Snapp | Dietitian, Registered | 1100 F Ave, Douglas, AZ 85607-1919 | 2016-02-29 |
| 1497131510 | Christopher Rogowski | Dentist | 1100 F Ave, Douglas, AZ 85607-1919 | 2015-07-31 |
| 1578996468 | Luis Ernesto Garcia Suero | Internal Medicine | 1100 F Ave, Douglas, AZ 85607-1919 | 2013-08-14 |
| 1437582558 | Juan Salvador Perez Gomez | Internal Medicine | 1100 F Ave, Douglas, AZ 85607-1919 | 2013-08-13 |
| 1275965683 | Maryslenni Gil | Internal Medicine | 1100 F Ave, Douglas, AZ 85607-1919 | 2013-08-08 |
| 1659614386 | Primarosa A Cardenas | Family Medicine | 1100 F Ave, Douglas, AZ 85607-1919 | 2013-04-01 |
| 1346594462 | Galyna Rudnikova Flink | Dentist | 1100 F Ave, Douglas, AZ 85607-1919 | 2012-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
| 1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
| 1609279108 | Walter Tucker | Counselor | 2100 E 8th, Douglas, AZ 85607 | 2014-09-29 |
| 1851700488 | Gerardo Grijalva | Non-emergency Medical Transport (VAN) | 2714 E 6th St, Douglas, AZ 85607 | 2014-08-07 |
| 1174933246 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1019 F Ave, Douglas, AZ 85607 | 2014-04-29 |
| 1831473164 | Cheryl Lynn Mcneeley | Speech-Language Pathologist | 815 E. 15th Street, Douglas, AZ 85607 | 2011-10-05 |
| 1245523364 | Community Intervention Associates | Community/Behavioral Health | 1701 North Douglasave, Douglas, AZ 85607 | 2011-05-23 |
| 1174820898 | Chiricahua Community Health Centers, Inc | Clinic/Center | 815 15th Street, Douglas, AZ 85607 | 2011-02-15 |
| 1033319512 | Community Healthcare of Douglas Inc | Clinic/Center | 1906 11th Street, Douglas, AZ 85607 | 2007-07-23 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| Find all providers in zip 85607 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750637575 | Alexandra Nicole Keeler | Dentist | 1010 E Richards St, Douglas, WY 82633-2970 | 2012-07-30 |
| 1578698650 | Guy W Moorman Jr. | Dentist | 1150 Ward St W, Magnolia Place B2, Douglas, GA 31533-1902 | 2007-02-22 |
| 1679657407 | Martin George Raebel II | Dentist | 430 Wiley Road, Douglas, MI 49406 | 2006-10-25 |
| 1477649598 | James Timothy Fussell | Dentist | 1390 Gordon St W, Douglas, GA 31533-3432 | 2006-10-05 |
| 1326130501 | South Georgia Cosmetic & General Dentistry | Dentist | 1108 Madison Ave N, Douglas, GA 31533-2802 | 2006-09-28 |
| 1629173422 | Bryan Curtis Cropper | Dentist | 811 Grant St, Douglas, WY 82633-2920 | 2006-09-14 |
| 1104834134 | Mark W Townsend | Dentist | 820 So 10th, Douglas, WY 82633 | 2006-08-04 |
| 1619995230 | Barbara Taipale Scanlon | Dentist | 341 Main St., Douglas, MA 01516-1047 | 2006-07-18 |
| 1134147242 | Gregory M Thackston | Dentist | 506 Madison Ave N, Douglas, GA 31533-4616 | 2006-07-17 |
| 1124562335 | Shailza D Sharma Dmd PC | Dentist | 341 Main St, Douglas, MA 01516-2182 | 2016-12-06 |
| Find all providers in DOUGLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.