NPIMap

Organization Active NPI

Idental Center, PSC

  • Oral and Maxillofacial Surgery (Dentist)
  • Yabucoa, PR
National Provider Identifier
1912200908
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2673 Issued in PR
Legal business name
IDENTAL CENTER, PSC
Practice address
A5 Street 1
Urbanizacion Villa Hilda
Yabucoa, PR 00767
Phone
(787) 266-3140
NPI assigned
Dec 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

Name
Maria I Gomez
Title
Manager
Phone
(787) 266-3140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 2673 PR Primary

Addresses

Primary practice location

A5 Street 1
Urbanizacion Villa Hilda
Yabucoa, PR 00767

Mailing address

PO Box 1198
Las Piedras, PR 00771-1198

National Provider Directory

National Provider Directory
Tax ID family
Idental Center PSC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1912200908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "007711198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A5 STREET 1",
            "address_2": "URBANIZACION VILLA HILDA",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "00767",
            "telephone_number": "787-266-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTAL CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "787-266-3140"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PR",
            "license": "2673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yabucoa, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.