1841779477 NPI number — TEACHABLE MOMENTS THERAPY GROUP

Table of content: DR. ALFRED RICHARD SALCIDO DDS (NPI 1043375637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841779477 NPI number — TEACHABLE MOMENTS THERAPY GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEACHABLE MOMENTS THERAPY GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841779477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 EATON ST STE 502
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23669-4055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-535-9080
Provider Business Mailing Address Fax Number:
757-257-8959

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 EATON ST STE 502
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMPTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23669-4055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-535-9080
Provider Business Practice Location Address Fax Number:
757-251-6467
Provider Enumeration Date:
08/14/2018

Additional Information

Authorized Official

Authorized Official Last Name:
DAWKINS
Authorized Official First Name:
SYREETA
Authorized Official Middle Name:
TIARA
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
757-535-9080

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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