Benanette Medina, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

003329 Issued in PR

Practice address

Pineiro Ave
Plaza El Amal Oficina 211
San Juan, PR 00927-0092

Phone

(787) 765-2679

NPI assigned

Jul 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1629564240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "address_2": "PMB 753",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-234-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PINEIRO AVE",
            "address_2": "PLAZA EL AMAL OFICINA 211",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009270092",
            "telephone_number": "787-765-2679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Calle De La Candelaria",
            "address_purpose": "LOCATION",
            "city": "Mayaguez",
            "state": "PR",
            "postal_code": "006823202",
            "country_code": "US",
            "telephone_number": "787-234-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "BENANETTE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PR",
            "license": "003329",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aida Eugenia Medina, MD
• Alejandra Medina, MD
• Alexandra Marie Medina, PSY.D.
• Angela M Medina, O.D.
• Beatriz Medina, PSYD
• Carmen Teresa Medina, DPT
• Carolina Medina
• Doris G Medina, LND,RD
• Edwin Jose Medina
• Haydee Medina, CLINICAL NURSE SPECI

• Pediatric Dentistry in San Juan, PR
• Providers in San Juan, PR by specialty
• Pediatric Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.