SAN PATRICIO DENTAL, LLC (NPI# 1003168675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003168675 |
| Entity Type | Organization |
| Organization Name | SAN PATRICIO DENTAL, LLC |
| Practice Address |
101 Ave San Patricio Maramar Plaza Suite 1210 Guaynabo PR 00968-2645 |
| Practice Telephone | 7875650134 |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |
| Authorized Official Name | DR. ANABELLE M MUDAFORT (PRESIDENT) |
| Authorized Official Telephone | 7875650134 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
2808 | PR | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2787 | PR | Dental Providers |
| Street Address |
101 AVE SAN PATRICIO MARAMAR PLAZA SUITE 1210 |
| City | GUAYNABO |
| State | PR |
| Zip Code | 00968-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649240813 | Carmen L Baez-franceschi | Specialist | 101 Ave San Patricio, Maramar Plaza, Suite 1060, Guaynabo, PR 00968-2645 | 2006-01-23 |
| 1275959884 | Puerto Rico Citylabs LLC | Clinical Medical Laboratory | 101 Ave San Patricio, Maramar Plaza, Suite G2, Guaynabo, PR 00968-2645 | 2014-03-07 |
| 1801145958 | Juliana Pollock | Physical Therapist | 101 Ave San Patricio, Suite 1150, Guaynabo, PR 00968-2645 | 2012-09-05 |
| 1164771622 | Gybelle, PC | Obstetrics & Gynecology | 101 Ave San Patricio, Maramar Plaza Suite 1090, Guaynabo, PR 00968-2645 | 2012-08-30 |
| 1144596537 | Centro De Periodoncia E Implantes De Pr, Psc | Dentist | 101 Ave San Patricio, Ste. 830, Guaynabo, PR 00968 | 2012-03-29 |
| 1457633448 | Star Kids Club-cbs Prediatric | Exclusive Provider Organization | 101 Ave San Patricio, Maramar Plaza, Guaynabo, PR 00968-2645 | 2011-09-15 |
| 1780975227 | Lisandra Pagan Santiago | Obstetrics & Gynecology | 101 Ave San Patricio, Suite 1130, Guaynabo, PR 00968-2645 | 2011-05-02 |
| 1386959633 | Juan Carlos Malpica-santiago | Internal Medicine | 101 Ave San Patricio, Suite 1240, Guaynabo, PR 00968-3057 | 2010-08-11 |
| 1629392527 | Ricardo A Hernandez-castillo | Internal Medicine | 101 Ave San Patricio, Maramar Plaza Suite 1240, Guaynabo, PR 00968 | 2010-03-22 |
| 1699004366 | Caribbean Urogynecology Associates Psc | Obstetrics & Gynecology | 101 Ave San Patricio, Maramar Plaza Suite 1090, Guaynabo, PR 00968-2645 | 2009-12-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820820 | Stat Mobile Diagnostic Imaging Group LLC | Physiological Laboratory | Metro Park 7, Street # 1, Suite 305, Guaynabo, PR 00968 | 2020-10-30 |
| 1881291300 | Smart Assistance Services Inc. | Non-emergency Medical Transport (VAN) | Calle 1, Metro Office Park 8, Suite 306, Guaynabo, PR 00968 | 2020-10-07 |
| 1245845064 | Felix Guerra | Pharmacist | 1 Ave Roosevelt, Guaynabo, PR 00968 | 2020-09-09 |
| 1144852138 | Sebastian Quinones | Clinic/Center | Urb Caparra Hills, E-6 Calle Eucalipto, Guaynabo, PR 00968 | 2020-02-07 |
| 1427691146 | Janice Gonzalez-sanchez | Psychologist | San Patricio Office Center, Calle Tabonuco 7 Suite 104, Guaynabo, PR 00968 | 2019-10-25 |
| 1548802853 | Freddie Boria Sr. | Ambulance | 100 Carr. 165 Centro Internacional De Mercadeo, Suite 409, Guaynabo, PR 00968 | 2019-10-09 |
| 1689238404 | Clinica Terapeutica Mon Quiromasaje, Psc | Massage Therapist | City View Plaza 48 Pr 165, Torre I Suite P 100, Guaynabo, PR 00968 | 2019-04-26 |
| 1831673573 | United Three Brothers Inc. | Pharmacy | 1498 Avenida Roosevelt Local 19a, Plaza Caparra Shopping Center, Guaynabo, PR 00968 | 2018-09-19 |
| 1649762378 | Citywide Group, Inc. | Ambulance | 100 Carr 165 Centro Internacional De Mercadeo, Suite 409, Guaynabo, PUERTO RICO 00968 | 2018-05-30 |
| 1063919124 | Centro De Reconstruccion Oral E Implantes | Clinic/Center | Calle 1 Esq 6 Urb Parkside Cond San Patricio II, Suite 1, Guaynabo, PR 00968 | 2018-04-06 |
| Find all providers in zip 00968 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285878587 | Optimum Dental Care, Csp | Dentist | 107 Ave Ortegon Ste 202, Caparra Gallery Building, Guaynabo, PR 00966-2517 | 2009-04-30 |
| 1164548053 | Damaris Molina | Dentist | 200 Plaza Guaynabo, Suite 200, Guaynabo, PR 00969-3481 | 2007-03-22 |
| 1447309273 | Ithamar Castro | Dentist | 107 Ave. Ortegon, Caparra Gallery Bld. Ste. 202, Guaynabo, PR 00966-2517 | 2007-01-10 |
| 1871664938 | Emilio Agrait-defillo | Dentist | B3 Ave Alejandrino, Guaynabo, PR 00969-4702 | 2006-11-12 |
| 1912088451 | Karla Michelle Maldonado | Dentist | 101 Ave San Patricio Ste 830, Maramar Plaza, Guaynabo, PR 00968-2679 | 2006-10-18 |
| 1003811910 | Maria Mercedes De Thomas | Dentist | Calle Diamante #a-20 Golden Gate, Caparra, Guaynabo, PR 00968-3413 | 2005-06-16 |
| 1508286048 | Smile 4 Kids, Pediatric Dentistry, Csp | Dentist | 1 Ave Arbolote, Plaza Real Shopping Center, Suite 205, Guaynabo, PR 00969-2806 | 2014-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083198576 | San Juan Dental Center LLC | Dentist | 456 Calle Cesar Gonzalez, San Juan, PR 00918-2628 | 2018-09-20 |
| 1235678608 | Karla Gabriela Alacan-rios | Dentist | 540 Ave Miramar Ste 6, Arecibo, PR 00612-4366 | 2017-02-18 |
| 1366801185 | Healthy Smiles LLC | Dentist | Carr 156 Plaza Los Prados, Suite Z1, Caguas, PR 00725 | 2016-02-22 |
| 1255707568 | Cr Diaz Bonilla Dentista Pediatrica Psc | Dentist | 51 Ave San Jose, Suite 203, Aibonito, PR 00705 | 2015-08-20 |
| 1174919732 | Jessica M Laguna Rodriguez | Dentist | Plaza Del Carmen Mall, Pr 172 Int Pr 1 Suite 22, Caguas, PR 00725 | 2015-04-10 |
| 1932510211 | Lionel Noel Vera-caraballo | Dentist | 274 Via De La Vereda, Vallw San Luis, Caguas, PR 00725 | 2014-05-08 |
| 1639410475 | Lomas Verdes Family Dental Csp | Dentist | Cond Laurel # Z30, Urb Lomas Verdes, Bayamon, PR 00956-3273 | 2013-03-04 |
| 1194029546 | Sunghee Kwak | Dentist | 7 Sylvan Avenue, Englewood Cliffs, PR 07632-2413 | 2010-12-28 |
| 1366746901 | Centro Denal Pediatrico Smiles 'r' Us Csp | Dentist | Calle Pimentel #45, 2nd Floor, Rio Grande, PR 00745 | 2010-12-22 |
| 1558527085 | Lenna M Aviles | Dentist | Marginal Cana Calle 5 Pp-14, Bayamon, PR 00957 | 2008-08-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.