Healthcare Provider Details

I. General information

NPI: 1801643895
Provider Name (Legal Business Name): MARIA CRISTINA SEPULVEDA FIGUEROA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 AVE PONCE DE LEON APT 1041
SAN JUAN PR
00909-5059
US

IV. Provider business mailing address

1511 AVE PONCE DE LEON APT 1041
SAN JUAN PR
00909-5059
US

V. Phone/Fax

Practice location:
  • Phone: 787-209-7550
  • Fax:
Mailing address:
  • Phone: 787-209-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number26578
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number003460
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: