SERVICIOS ESPECIALIZADOS DE ORTODONCIA NPI 1003004714

Clinic/Center (Dental) in San Juan, PR

About SERVICIOS ESPECIALIZADOS DE ORTODONCIA

Servicios Especializados De Ortodoncia is a provider in San Juan, PR. The NPI number assigned to this provider is 1003004714. The practitioner's primary taxonomy code is Clinic/Center (261QD0000X). The provider is registered as an organization and their NPI record was last updated 10 years ago.

NPI1003004714 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameSERVICIOS ESPECIALIZADOS DE ORTODONCIA
Provider Location AddressOFFICE 12 65 INFANTERIA RIO PIEDRAS CENT COM LOS FLAMBOYANES SAN JUAN, PR 00924 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressOFFICE 12 65 INFANTERIA CENT COM LOS FLAMBOYANES SAN JUAN, PR 00924 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date10-09-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-09-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

SERVICIOS ESPECIALIZADOS DE ORTODONCIA
OFFICE 12 65 INFANTERIA RIO PIEDRAS
CENT COM LOS FLAMBOYANES
SAN JUAN, PR
ZIP 00924
Phone: (178) 775-8156
Fax: (178) 775-8151
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Mailing Address

SERVICIOS ESPECIALIZADOS DE ORTODONCIA
OFFICE 12 65 INFANTERIA
CENT COM LOS FLAMBOYANES
SAN JUAN, PR
ZIP 00924
Phone: (178) 775-8156
Fax: (178) 775-8151

Primary Taxonomy

Taxonomy Code261QD0000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationDental
License No.864
License StatePR

Authorized Official

Authorized Official NameDR. VICTOR L ACEVEDO DMD ,MS Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePRESIDENT
Authorized Official Phone

Map Location


SERVICIOS ESPECIALIZADOS DE ORTODONCIA address is OFFICE 12 65 INFANTERIA RIO PIEDRAS CENT COM LOS FLAMBOYANES SAN JUAN, PR 00924