Healthcare Provider Details

I. General information

NPI: 1962319467
Provider Name (Legal Business Name): AYALA DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CALLE GAUTIER BENITEZ
CAGUAS PR
00725-7200
US

IV. Provider business mailing address

F52 CALLE 34A
CAGUAS PR
00727-6748
US

V. Phone/Fax

Practice location:
  • Phone: 787-745-6220
  • Fax:
Mailing address:
  • Phone: 787-210-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAVENNYS MARIE AYALA VAZQUEZ
Title or Position: DENTIST
Credential: DMD
Phone: 787-210-2046