Healthcare Provider Details

I. General information

NPI: 1912886730
Provider Name (Legal Business Name): DENTAL4LIFE CARIBBEAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 PASEO DEL VALLE
LAJAS PR
00667-9009
US

IV. Provider business mailing address

7 PASEO DEL VALLE
LAJAS PR
00667-9009
US

V. Phone/Fax

Practice location:
  • Phone: 787-433-7242
  • Fax:
Mailing address:
  • Phone: 787-433-7242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC A JIMENEZ
Title or Position: PRESIDENTE
Credential: DR
Phone: 787-433-7242