Anabelle Marie Mudafort, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2787 Issued in PR

Practice address

101 Ave San Patricio Ste 1210
Guaynabo, PR 00968-3054

Phone

(787) 946-0277

Fax

(787) 946-0024

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1649469370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVE SAN PATRICIO STE 1210",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009683054",
            "telephone_number": "787-946-0277",
            "fax_number": "787-946-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 AVE SAN PATRICIO STE 1210",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009683054",
            "telephone_number": "787-946-0277",
            "fax_number": "787-946-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDAFORT",
        "first_name": "ANABELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PR",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Guaynabo, PR
• Providers in Guaynabo, 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 Jul 15, 2022; 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.