Concepcion C Quintero, DMD

Individual provider Active NPI General Practice Dentistry · Comerio, PR

NPI 1851408421 · NPPES record last updated Jan 10, 2008

Key facts

NPI
1851408421
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D1645 (PR)
Practice address
Bo. Vega Redonda,Carretera 778, Sector Pasarell
Pabellon de Servicios
Comerio, PR 00782
Phone
(787) 875-2190
Fax
(787) 875-2342
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR
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
I20160414001709 PR Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
8426356007

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
D1645PRMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D1645 PR Yes

Addresses

Primary practice location

Bo. Vega Redonda,Carretera 778, Sector Pasarell
Pabellon de Servicios
Comerio, PR 00782

Mailing address

323 Camino del Guama
Sabanera Dorado
Dorado, PR 00646-3619
Phone (787) 626-6581

Other identifiers

IdentifierTypeStateIssuer
D 1645OtherPRDELTA DENTAL
D000117OtherPRPLAN MENONITA
2240OtherPRINTL MEDICAL CARD
9610002OtherPRHUMANA PR
041358OtherPRCRUZ AZUL DE PR
41619OtherPRTRIPLE S
206008OtherPRPREFFERRED HEALTH

Other providers in Comerio, PR

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

Sources for this page

Verify at the official NPI Registry.