NPIMap

Organization Active NPI

Licdentalandmedicalcsp

  • General Practice Dentistry
  • Canovanas, PR
National Provider Identifier
1164706297
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LICDENTALANDMEDICALCSP
Practice address
Palmer/Hernaiz Ave St #74
Ste 2
Canovanas, PR 00729-1617
Phone
(787) 256-3115
NPI assigned
Oct 7, 2011
Last updated
Oct 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Authorized official

Name
Dr. Luis IturrinoNPI 1659329282
Title
President
Phone
(787) 256-3115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

Palmer/Hernaiz Ave St #74
Ste 2
Canovanas, PR 00729-1617

Mailing address

PO Box 1617
Canovanas
Canovanas, PR 00729-1617
Phone (787) 256-3115

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1164706297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1617",
            "address_2": "CANOVANAS",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007291617",
            "telephone_number": "787-256-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PALMER/HERNAIZ AVE ST #74",
            "address_2": "STE 2",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007291617",
            "telephone_number": "787-256-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICDENTALANDMEDICALCSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "ITURRINO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-256-3115",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canovanas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.