Healthcare Provider Details

I. General information

NPI: 1669204301
Provider Name (Legal Business Name): DIANA YISELL SILVA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CALLE RODRIGO DE TRIANA
SAN JUAN PR
00918-3215
US

IV. Provider business mailing address

235 CALLE RODRIGO DE TRIANA
SAN JUAN PR
00918-3215
US

V. Phone/Fax

Practice location:
  • Phone: 787-671-1062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3598
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065478
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI031374000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: