Ivette M Negron, D.M.D.

Individual provider Active NPI General Practice Dentistry · Loiza, PR

NPI 1891862884 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1891862884
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
1611 (PR)
Practice address
Carretera #188 Int. #187
Loiza, PR 00772
Phone
(787) 876-2042
Fax
(787) 256-1900
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
I20160329000123 PR Order and Referring Only - Dentist
Practitioner - Dentist
2365749843

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1611PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Concilio de Salud Integral de Loiza Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1611 PR Yes

Addresses

Primary practice location

Carretera #188 Int. #187
Loiza, PR 00772

Mailing address

MB79 Paseo del Sol
Parque del Monte, Encantada
Trujillo Alto, PR 00976-6092
Phone (787) 876-2042

Other providers in Loiza, PR

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

Sources for this page

Verify at the official NPI Registry.