Dietrich Dental P.S.C

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

2179 Issued in PR

Legal business name

DIETRICH DENTAL P.S.C

Practice address

La Galeria Suchville 97 Carr 2
Ste 208
Guaynabo, PR 00966

Phone

(787) 705-5063

Fax

(787) 705-5065

NPI assigned

Dec 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rene Dietrich-Trigo, DMD

Title

Dentist

Phone

(787) 705-5063

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1689819260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LA GALERIA SUCHVILLE 97",
            "address_2": "CARR. 2 SUITE 208",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-705-5063",
            "fax_number": "787-705-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LA GALERIA SUCHVILLE 97 CARR 2",
            "address_2": "STE 208",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-705-5063",
            "fax_number": "787-705-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETRICH DENTAL P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "DIETRICH-TRIGO",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "787-705-5063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PR",
            "license": "2179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Health Maintenance Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.