Lissandra Maria Vazquez Grillo

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

00000000 Issued in PR

Practice address

Universidad de Puerto Rico
Recinto de Sciencias Medicas
San Juan, PR 00935-0001

Phone

(787) 758-2525

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bravaz Dental LLC

  • Dentist
  • Hollywood, FL
  • NPI 1265011688
  NPD Authorized official

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1952831711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CALLE VALCALCER",
            "address_2": "COOPERATIVA DE VIVIENDAS EL ALCAZAR APARTAMENTO 17 J",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSIDAD DE PUERTO RICO",
            "address_2": "RECINTO DE SCIENCIAS MEDICAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-758-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ GRILLO",
        "first_name": "LISSANDRA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "PR",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guillermo Jose Vazquez Fernandez
• Leslie A. Vazquez Garcia
• Betsy Vazquez Gomez, MD
• Carlos R. Vazquez Gonzalez, M.D.
• Jeniffer M. Vazquez Gonzalez
• Alondra Edithza Vazquez Hernandez
• Myrna Enid Vazquez Hernandez
• Lisandrie Marie Vazquez Lopez
• Natalia Vazquez Lopez, LPC
• Blanca Vazquez Marrero

• Public Health Dentistry in San Juan, PR
• Providers in San Juan, PR by specialty
• Public Health Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.