Healthcare Provider Details

I. General information

NPI: 1346104429
Provider Name (Legal Business Name): SD DENTAL PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAPARRA GALLERY 107 AVE ORTEGON SUITE 306
GUAYNABO PR
00966
US

IV. Provider business mailing address

COND. ATRIUM PARK APT 703C CALLE REGINA MEDINA 37
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-273-6810
  • Fax:
Mailing address:
  • Phone: 787-244-1591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SOLEIL DENIE RIVERA FIGUEROA
Title or Position: PRESIDENT/OWNER
Credential: DMD
Phone: 787-224-1591