Agnes Lynette Berrios, D.M.D.
Individual provider Active NPI General Practice Dentistry · Canovanas, PR
NPI 1972652162 · NPPES record last updated Dec 2, 2016
Key facts
- NPI
- 1972652162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1281 (PR)
- Practice address
- 103 Calle Autonomia
Canovanas, PR 00729-3297 - Phone
- (787) 876-2100
- Fax
- (787) 876-2100
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1281 | PR | MD | Nutrition Education Nutritionist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1281 | PR | Yes |
Addresses
Primary practice location
103 Calle Autonomia
Canovanas, PR 00729-3297
Mailing address
103 Calle Autonomia
Canovanas, PR 00729-3297
Phone (787) 876-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1281 | Other | PR | DMD L ICENCE |
Other providers in Canovanas, PR
- Liz Marie Baez Torres
- Barreto Eye Clinic
- Aida Liz Barreto Rodriguez
- Lorenzo Berberena
- Taina Marie Berrios Rodriguez
- Jan L Betancourt
- Better Choice Laboratories Corp
- Bienestar Integral Corp
- Bio-Medical Applications of Puerto Rico, Inc.
- Ed Bonano
All providers in Canovanas, PR · General Practice Dentistry in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.