Clinica Dental Canton Mall

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0982 Issued in PR

Legal business name

CLINICA DENTAL CANTON MALL

Practice address

Rio Hondo
PMB Suite 452
Bayamon, PR 00961-3106

Phone

(787) 785-3170

Fax

(787) 785-3170

NPI assigned

Dec 17, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jose Antonio Aguirre, D.M.D.

Title

Chief of Staff

Phone

(787) 785-3170

Specialties & licenses 1

Addresses

Other names 1

• Clinica Dental Canton Mall Doing business as

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1760711964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RIO HONDO AVE",
            "address_2": "PMB SUITE 452",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613110",
            "telephone_number": "787-785-3170",
            "fax_number": "787-785-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIO HONDO",
            "address_2": "PMB SUITE 452",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613106",
            "telephone_number": "787-785-3170",
            "fax_number": "787-785-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DENTAL CANTON MALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "CHIEF OF STAFF",
        "authorized_official_telephone_number": "787-785-3170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "0982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Dental Canton Mall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Bayamon, PR
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.