Dental Services Network LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL SERVICES NETWORK LLC

Practice address

1225 Ave Ponce de Leon Ste 606
San Juan, PR 00907-3907

Phone

(703) 859-3367

NPI assigned

Jun 18, 2021

Last updated

Jul 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ted Richan

Title

Coo

Phone

(703) 859-3367

Specialties & licenses 1

Addresses

Other names 1

• Dental Office Management Services LLC Former legal business name

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1568031144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 AVE PONCE DE LEON STE 606",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073907",
            "telephone_number": "703-859-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 AVE PONCE DE LEON STE 606",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009073907",
            "telephone_number": "703-859-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "RICHAN",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "703-859-3367"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Office Management Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.