Marien Blanco, D.M.D
Individual provider Active NPI Dentist · Aguadilla, PR
NPI 1881795698 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1881795698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2652 (PR)
- Practice address
- 2053 Ave Pedro Albizu Campos
Suite #1
Aguadilla, PR 00603-5950 - Phone
- (787) 891-3430
- Fax
- (787) 891-6294
- NPI assigned
- Sep 26, 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180412000180 | PR | Order and Referring Only - Dentist |
1658634209 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2652 | PR | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2652 | PR | Yes |
Addresses
Primary practice location
2053 Ave Pedro Albizu Campos
Suite #1
Aguadilla, PR 00603-5950
Mailing address
2053 Ave Pedro Albizu Campos
Suite 2 PMB 115
Aguadilla, PR 00603-5950
Phone (787) 891-3430
Other providers in Aguadilla, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.