Trujillo Dental Clinic PSC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0450 Issued in PR

Legal business name

TRUJILLO DENTAL CLINIC PSC

Doing business as

TRUJILLO DENTAL CLINIC PSC

Practice address

206 Calle Dr Fernandez
206 Dr Fernandez
Trujillo Alto, PR 00976-5939

Phone

(787) 755-3045

Fax

(787) 292-0277

NPI assigned

Jul 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jorge Velazquez Ramon, DMD

Title

President

Phone

(787) 755-3045

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• TRUJILLO DENTAL CLINIC PSC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1104139914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51597",
            "address_2": "PO BOX 51597",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009501597",
            "telephone_number": "787-755-3045",
            "fax_number": "787-292-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CALLE DR FERNANDEZ",
            "address_2": "206 DR FERNANDEZ",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009765939",
            "telephone_number": "787-755-3045",
            "fax_number": "787-292-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUJILLO DENTAL CLINIC PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ RAMON",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-755-3045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "0450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083642029",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114006079",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164410619",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184793374",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRUJILLO DENTAL CLINIC PSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Trujillo Alto, PR
• Providers in Trujillo Alto, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.