Pro Medical Dental Group LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PRO MEDICAL DENTAL GROUP LLC

Practice address

Carr 924 KM 3.3 Barrio Pitahaya
Humacao, PR 00791

Phone

(787) 955-2901

NPI assigned

Nov 19, 2021

Organization subpart

No

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

Authorized official

Name

Mariela E Torres Cruz

Title

Facturadora

Phone

(787) 955-2901

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1699432013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 CALLE FLAMBOYAN",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 924 KM 3.3 BARRIO PITAHAYA",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-955-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MEDICAL DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "TORRES CRUZ",
        "authorized_official_first_name": "MARIELA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "FACTURADORA",
        "authorized_official_telephone_number": "787-955-2901"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.