Antonia H Alfonso-Pagan, D.M.D.
Individual provider Active NPI General Practice Dentistry · Guaynabo, PR
NPI 1265626915 · NPPES record last updated Mar 6, 2015
Key facts
- NPI
- 1265626915
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2807 (PR)
- Practice address
- B-15 Street 2
Parkside
Guaynabo, PR 00968 - Phone
- (787) 793-7040
- NPI assigned
- Sep 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| I20150708002821 | PR | Order and Referring Only - Oral Surgery |
0143532887 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2807 | PR | MD | School Psychologist |
| 054152 | NY | MD | General Practice Dentistry |
| DS037825 | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2807 | PR | Yes |
| General Practice Dentistry | 1223G0001X | 054152 | NY | |
| General Practice Dentistry | 1223G0001X | DS037825 | PA |
Addresses
Primary practice location
B-15 Street 2
Parkside
Guaynabo, PR 00968
Mailing address
PO Box 195152
San Juan, PR 00919-5152
Phone (787) 457-5999
Other providers in Guaynabo, PR
- Sydney Ivelisse Alejandro Caro
- Alenis Alejandro Escribano
- Wanda Alejandro Rivera
- Karla C Alejandro
- Jesus Alequin Rosado
- Jennifer Alfonso
- Amelia Algarin Saez
- Jackeline Algarin Santiago
- Alianza de Centros de Salud Comunitaria Ma, Inc
- Hector Ruben Alicea Rodriguez
All providers in Guaynabo, PR · General Practice Dentistry in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2015. 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.