Ivan R Aponte, DMD

Individual provider Active NPI General Practice Dentistry · San Lorenzo, PR

NPI 1821130840 · NPPES record last updated Feb 19, 2024

Key facts

NPI
1821130840
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
00903 (PR)
Practice address
No 64 Jose de Diego St
San Lorenzo, PR 00754
Phone
(787) 736-5736
Fax
(787) 736-5736
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160914000369 FL Order and Referring Only - Other (Physician)
Practitioner - Other (Physician)
7214223437

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
00903PRMDGeneral Practice Dentistry
903PRMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 00903 PR Yes

Addresses

Primary practice location

No 64 Jose de Diego St
San Lorenzo, PR 00754

Mailing address

No 64 Jose de Diego Street
PO Box 26
San Lorenzo, PR 00754
Phone (787) 736-5736

Other providers in San Lorenzo, PR

All providers in San Lorenzo, PR · General Practice Dentistry in Puerto Rico

Sources for this page

Verify at the official NPI Registry.