NPI Code Detail JSON Logo

1902874712 NPI number — DENTO-LAB, INC

NPI Number: 1902874712
Health Care Provider/Practitioner: DENTO-LAB, INC

Information about “1902874712” NPI (DENTO-LAB, INC) exists in 1902874712 in HTML format HTML  |  1902874712 in plain Text format TXT  |  1902874712 in PDF (Portable Document Format) PDF  |  1902874712 in an XML format XML  formats.

NPI Number : 1902874712 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902874712",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "DENTO-LAB, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "HC 03 BOX 25708",
    "SecondLineMailingAddress": "SAN GERMAN MEDICAL PLAZA",
    "MailingAddressCityName": "SAN GERMAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00683-9339",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-892-8585",
    "MailingAddressFaxNumber": "787-892-8585",
    "FirstLinePracticeLocationAddress": "CARR #2, RM 174, SUITE 101",
    "SecondLinePracticeLocationAddress": "SAN GERMAN MEDICAL PLAZA",
    "PracticeLocationAddressCityName": "SAN GERMAN",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00683-9339",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-892-8585",
    "PracticeLocationAddressFaxNumber": "787-892-8585",
    "EnumerationDate": "03/08/2006",
    "LastUpdateDate": "12/23/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "VARGAS",
    "AuthorizedOfficialFirstName": "FREDICKSON",
    "AuthorizedOfficialMiddleName": "M.",
    "AuthorizedOfficialTitle": "PRESIDENT-DENTO-LAB, INC",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "787-892-8585",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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