MEDICARE: DAYANISE ROMAN BELTRAN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3510	PR
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1073205894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYANISE ROMAN BELTRAN DMD

Provider Business Mailing Address
First Line	:	URB EL ROSARIO 2
Second Line	:	CALLE 5 R 21
City	:	VEGA BAJA
State	:	PR
Zip	:	00693
Country	:	US
Telephone Number	:	787-501-8992
Fax Number	:

Provider Business Practice Location Address
First Line	:	PLAZA LAS VEGAS
Second Line	:
City	:	VEGA BAJA
State	:	PR
Zip	:	00693-5242
Country	:	US
Telephone Number	:	787-855-5342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	11/16/2025

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