Individual provider Active NPI

Isabel Liranza Dominguez, DMD

  • Dentist
  • San Juan, PR
National Provider Identifier
1265613798
Registry record updated Oct 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D2054 Issued in PR
Practice address
1057 Calle William Jones
San Juan, PR 00925-3832
Phone
(787) 764-8696
Fax
(787) 756-8427
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D2054 PR Primary

Addresses

Primary practice location

1057 Calle William Jones
San Juan, PR 00925-3832

Mailing address

1068 Ave Barbosa
San Juan, PR 00925-3223
Phone (787) 764-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161103002400 PR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3173801651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D2054PRMDDentist
2054PRMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Dental Liranza General Practice CurrentSince Nov 27, 2022 Accepting new patients

Locations

1173 Calle Maximo Alomar
San Juan, PR 00923
Phone (787) 447-1884

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477094400000",
    "number": "1265613798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 AVE BARBOSA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009253223",
            "telephone_number": "787-764-8696",
            "fax_number": "787-756-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 CALLE WILLIAM JONES",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009253832",
            "telephone_number": "787-764-8696",
            "fax_number": "787-756-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRANZA DOMINGUEZ",
        "first_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2016-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "D2054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.