Active NPI
Wanda I Ortiz, DDS
- Dentist
- San Juan, PR
National Provider Identifier
1609969799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2102
- Practice address
- 209 Ave Munoz Rivera
Suite 1410 Populas Center Plaza
San Juan, PR 00918 - Phone
- (787) 274-1741
- Fax
- (787) 274-1776
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2102 | PR | Primary |
Addresses
Primary practice location
209 Ave Munoz Rivera
Suite 1410 Populas Center Plaza
San Juan, PR 00918
Mailing address
209 Ave Munoz Rivera
Suite 1410 Populas Center Plaza
San Juan, PR 00918
Phone (787) 274-1741
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2102 | PR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609969799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 AVE MUNOZ RIVERA",
"address_2": "SUITE 1410 POPULAS CENTER PLAZA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-274-1741",
"fax_number": "787-274-1776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 AVE MUNOZ RIVERA",
"address_2": "SUITE 1410 POPULAS CENTER PLAZA",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-274-1741",
"fax_number": "787-274-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "WANDA",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PR",
"license": "2102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.