Healthcare Provider Details

I. General information

NPI: 1699862458
Provider Name (Legal Business Name): JORGE L RAMIREZ DE ARELLANO DENTISTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 CALLE DR VEVE
SAN GERMAN PR
00683-4031
US

IV. Provider business mailing address

PO BOX 24
SAN GERMAN PR
00683-0024
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-1398
  • Fax: 787-892-1398
Mailing address:
  • Phone: 787-892-1398
  • Fax: 787-892-1398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number2479
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: