MEDICARE: LENNA AVILES DENTAL LLC

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

General Provider Information

NPI Number	:	1366308538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENNA AVILES DENTAL LLC

Provider Business Mailing Address
First Line	:	1 AVE PALMA REAL APT 1311
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-7206
Country	:	US
Telephone Number	:	787-810-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR 1 INT CARR 172
Second Line	:	PLAZA DEL CARMEN MALL SUITE 22
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-745-6220
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LENNA M AVILES PORRATA-DORIA
Credential	:	DMD
Telephone Number	:	787-810-1332

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “LENNA AVILES DENTAL LLC ” Practice Location

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