Nydia Ribot
Individual provider Active NPI General Practice Dentistry · Fajargo, PR
NPI 1104886027 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1104886027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1368 (PR)
- Practice address
- Calle Diego Zalduonde
#316 Veve
Fajargo, PR 00738 - Phone
- (787) 863-9424
- Fax
- (787) 801-0859
- NPI assigned
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150817001000 | PR | Order and Referring Only - Dentist |
5092020321 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1368 | PR | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1368 | PR | Yes |
Addresses
Primary practice location
Calle Diego Zalduonde
#316 Veve
Fajargo, PR 00738
Mailing address
PO Box 1245
Fajardo, PR 00738
Phone (787) 863-9424
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.