Javier Adorno, DMD

Individual provider Active NPI General Practice Dentistry · Ponce, PR

NPI 1669536504 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669536504
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2582 (PR)
Practice address
917 Ave Tito Castro
Hospital San Lucas
Ponce, PR 00716-4717
Phone
(787) 290-3165
Fax
(787) 290-3191
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2582PRMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2582 PR Yes

Addresses

Primary practice location

917 Ave Tito Castro
Hospital San Lucas
Ponce, PR 00716-4717

Mailing address

PO Box 800159
Coto Laurel, PR 00780-0159
Phone (787) 290-3165

Other providers in Ponce, PR

All providers in Ponce, PR · General Practice Dentistry in Puerto Rico

Sources for this page

Verify at the official NPI Registry.