Healthcare Provider Details

I. General information

NPI: 1811008709
Provider Name (Legal Business Name): HECTOR FELIX MELENDEZ-DEDOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DE DIEGO #369 TORRE HOSPITAL SAN FRANCISCO SUITE 302
RIO PIEDRAS PR
00923
US

IV. Provider business mailing address

PO BOX 367228
SAN JUAN PR
00936-7228
US

V. Phone/Fax

Practice location:
  • Phone: 787-274-1505
  • Fax: 787-250-7517
Mailing address:
  • Phone: 787-273-7648
  • Fax: 787-250-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2101
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number044107 1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: