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General NPI Number Information
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NPI Number | 1912810557
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Entity Type | Organization
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Legal Business Name | LOURIDO PERIODONTICS, LLC
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 525 AVE F. D. ROOSEVELT SUITE 704 PLAZA LAS AMERICAS TOWER
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-767-7967
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Fax |
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Provider Business Mailing Address
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Address Line | GC28 CALLE 418
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City | CAROLINA
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State | PR
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Zip | 00982-1932
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Country | US
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Telephone | 939-539-0849
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Fax |
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Authorized Official
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Title or Position | PRESIDENT - PERIODONTIST
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Name | DR. GIAN DANIEL LOURIDO MARTINEZ
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Credential | DMD, MSD
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Telephone | 939-539-0849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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